- 
                                        
psnet.ahrq.gov/perspective/conversation-charles-crecelius-md-phd-cmd-and-lori-l-popejoy-phd-rn-faan
October 28, 2020 - CC : One unique thing about our industry is that we integrate with a lot of other sites and services
                                     
                                                                    - 
                                        
effectivehealthcare.ahrq.gov/sites/default/files/related_files/type-2-diabetes-medications-update_executive.pdf
March 01, 2011 - publication of that review,
enough studies were published to merit an update to
address research gaps and integrate
                                     
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digital.ahrq.gov/sites/default/files/docs/publication/r18hs017094-mccolm-final-report-2009.pdf
January 01, 2009 - necessary for data capture of quality measures in an 
ambulatory EHR system, 
 
• standardize and integrate
                                     
                                                                    - 
                                        
www.ahrq.gov/sites/default/files/2024-07/congdon-magilvy-report.pdf
January 01, 2024 - In a variety of healthcare arenas, report cards have been developed to integrate 
concise quality assessments
                                     
                                                                    - 
                                        
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/modules/onboarding/onboarding_overview_impmodel_facnotes.docx
December 01, 2017 - For example, you can integrate safety meetings with regularly scheduled nurse training, unit meetings
                                     
                                                                    - 
                                        
www.ahrq.gov/hai/tools/surgery/modules/on-boarding/overview-fac-notes.html
December 01, 2017 - For example, you can integrate safety meetings with regularly scheduled nurse training, unit meetings
                                     
                                                                    - 
                                        
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol2/Advances-Donaldson_87.pdf
April 23, 2008 - Site teams review, translate, and adapt 
literature; critique current practices and 
integrate potential
                                     
                                                                    - 
                                        
psnet.ahrq.gov/perspective/incident-reporting-more-attention-safety-action-feedback-loop-please
September 01, 2011 - reporting as just one of multiple strategies for soliciting input from providers about safety hazards, and integrate
                                     
                                                                    - 
                                        
psnet.ahrq.gov/perspective/long-term-care-and-response-covid-19
October 28, 2020 - CC : One unique thing about our industry is that we integrate with a lot of other sites and services
                                     
                                                                    - 
                                        
effectivehealthcare.ahrq.gov/sites/default/files/related_files/measuring-blood-pressure_disposition-comments.pdf
January 01, 2012 - trials, 
which would inform “real-world” effectiveness and report practical 
information on how best to integrate
                                     
                                                                    - 
                                        
www.ahrq.gov/patient-safety/reports/hotline/implement3.html
May 01, 2016 - Developing and Testing the Health Care Safety Hotline: A Prototype Consumer Reporting System for Patient Safety Events 
 III. Hotline Implementation and Refinement 
 
 
 
 
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                                                                    - 
                                        
www.ahrq.gov/patient-safety/reports/hotline/summary.html
May 01, 2016 - Developing and Testing the Health Care Safety Hotline: A Prototype Consumer Reporting System for Patient Safety Events 
 Summary 
 
 
 
 
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 Table of Contents 
 
 Developing and Testing the Health Care Safety Hotline: A Prototype Consumer Reporting System for Patient Safety Events 
 Preface 
 … 
                                     
                                                                    - 
                                        
psnet.ahrq.gov/web-mm/outbreak
January 29, 2015 - Outbreak 
 
 
 
 
 Citation Text: 
 Rothman R, Stapleton S. Outbreak. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2011. 
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psnet.ahrq.gov/web-mm/untimely-end-despite-end-life-care-planning
February 01, 2012 - An Untimely End Despite End-of-Life Care Planning 
 
 
 
 
 Citation Text: 
 Elia G, Barbour S, Anderson WG. An Untimely End Despite End-of-Life Care Planning. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2018. 
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psnet.ahrq.gov/perspective/safety-retail-pharmacy
May 11, 2016 - Safety in the Retail Pharmacy 
 Michelle A. Chui, PharmD, PhD | October 1, 2018 
                       
 
 
 
 
 
 
 View more articles from the same authors. 
 
 
 
 
 
 
 Citation Text: 
 Chui MA. Safety in the Retail Pharmacy. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Departme… 
                                     
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psnet.ahrq.gov/web-mm/dangerous-detour
November 28, 2018 - The Dangerous Detour 
 
 
 
 
 Citation Text: 
 Gibson J, HTaylor D. The Dangerous Detour. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2003. 
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psnet.ahrq.gov/web-mm/surprise-wire
July 15, 2020 - Surprise Wire 
 
 
 
 
 Citation Text: 
 Pearl JM, Donaldson NE. Surprise Wire. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2005. 
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psnet.ahrq.gov/web-mm/too-hot-comfort
May 19, 2015 - Too Hot For Comfort 
 
 
 
 
 Citation Text: 
 Cleland H, Wasiak J. Too Hot For Comfort. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2007. 
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psnet.ahrq.gov/web-mm/amphotericin-toxicity
April 01, 2014 - Amphotericin Toxicity 
 
 
 
 
 Citation Text: 
 Nagel J, Nguyen E. Amphotericin Toxicity. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2015. 
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psnet.ahrq.gov/node/49604/psn-pdf
June 01, 2010 - Tacit Handover, Overt Mishap
June 1, 2010
Cooper JB, Kamdar BB. Tacit Handover, Overt Mishap. PSNet [internet]. 2010.
https://psnet.ahrq.gov/web-mm/tacit-handover-overt-mishap
The Case
A 61-year-old man was admitted for management of an infected aortic stent, which had been placed 3
years earlier to treat an abdo…