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  1. www.ahrq.gov/sites/default/files/wysiwyg/topics/public-notes-meeting-summary-031121.pdf
    July 22, 2021 - Updates addressed during the meeting include the following: Agency Update AHRQ • New issue brief posted … congressional-report/115th-congress/senate-report/150/1 https://www.ahrq.gov/patient-safety/reports/issue-briefs … /healthit-ed.html https://www.ahrq.gov/patient-safety/reports/issue-briefs/healthit-ed.html https://www.ahrq.gov … /patient-safety/reports/issue-briefs/healthit-ed.html 2 Agency Update AHRQ (cont’d.) • Resources
  2. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/implementation/educational-bundles/communication-and-teamwork/communication-strategies.pptx
    September 01, 2016 - within a facility culture Describe how staff can use the CUS technique (concerned-uncomfortable-safety issue … of the issue. … If the conflict is not resolved, state that there is a safety issue. … It could be a safety issue if we don’t wash our hands first and Mrs. … Mary could say, "Jessica, it could be a safety issue if we don't wash our hands first and Mrs.
  3. www.ahrq.gov/news/newsletters/e-newsletter/914.html
    May 01, 2024 - AHRQ Views: Continuing a 35-Year History, AHRQ Pursues Vital Pathways To Improve Patient Care IssueIssue Brief Addresses Cognitive Load and its Impact on Diagnostic Accuracy . … Review additional new publications in PSNet’s  current issue , including recent cases and commentaries … Issue Brief Addresses Cognitive Load and its Impact on Diagnostic Accuracy A new AHRQ issue brief provides
  4. www.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/cusptoolkit/toolkit/Culture-Check-UpTool.docx
    June 02, 2025 - This can be an issue for which the average response is three or below or a domain score that shows less … establishing a tentative plan and timeline for carrying out an agreed-upon change that could improve the issue … If you have trend data across years, you could select an issue that has changed significantly.
  5. www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-culture-survey-brazil-summary.html
    August 01, 2024 - Learning from AHRQ's Diagnostic Safety Culture Survey at a Tertiary Care Health System in Brazil: A Case Study Summary of Survey Findings Previous Page Next Page Table of Contents Learning from AHRQ's Diagnostic Safety Culture Survey at a Tertiary Care Health System in Brazil: A Case Study Introdu…
  6. www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-culture-survey-brazil-approach.html
    August 01, 2024 - Learning from AHRQ's Diagnostic Safety Culture Survey at a Tertiary Care Health System in Brazil: A Case Study Initial Approach Previous Page Next Page Table of Contents Learning from AHRQ's Diagnostic Safety Culture Survey at a Tertiary Care Health System in Brazil: A Case Study Introduction In…
  7. www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-test-result-communication-references.html
    July 01, 2024 - Electronic Test Result Communication in the Era of the 21st Century Cures Act References Previous Page Next Page Table of Contents Electronic Test Result Communication in the Era of the 21st Century Cures Act Introduction Methods Results Discussion Conclusions References Appendix A. Da…
  8. www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-test-result-communication-apa.html
    July 01, 2024 - Electronic Test Result Communication in the Era of the 21st Century Cures Act Appendix A. Database Search Strategy Previous Page Next Page Table of Contents Electronic Test Result Communication in the Era of the 21st Century Cures Act Introduction Methods Results Discussion Conclusions R…
  9. www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-test-result-communication6.html
    July 01, 2024 - Electronic Test Result Communication in the Era of the 21st Century Cures Act Conclusions Previous Page Next Page Table of Contents Electronic Test Result Communication in the Era of the 21st Century Cures Act Introduction Methods Results Discussion Conclusions References Appendix A. D…
  10. www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-culture-survey-brazil-references.html
    August 01, 2024 - Learning from AHRQ's Diagnostic Safety Culture Survey at a Tertiary Care Health System in Brazil: A Case Study References Previous Page   Table of Contents Learning from AHRQ's Diagnostic Safety Culture Survey at a Tertiary Care Health System in Brazil: A Case Study Introduction Initial Approach…
  11. www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-culture-survey-brazil-actions.html
    August 01, 2024 - Learning from AHRQ's Diagnostic Safety Culture Survey at a Tertiary Care Health System in Brazil: A Case Study Actions Based on Survey Results Previous Page Next Page Table of Contents Learning from AHRQ's Diagnostic Safety Culture Survey at a Tertiary Care Health System in Brazil: A Case Study In…
  12. www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-test-result-communication5.html
    July 01, 2024 - Electronic Test Result Communication in the Era of the 21st Century Cures Act Discussion Previous Page Next Page Table of Contents Electronic Test Result Communication in the Era of the 21st Century Cures Act Introduction Methods Results Discussion Conclusions References Appendix A. Da…
  13. www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-test-result-communication-apb.html
    July 01, 2024 - Electronic Test Result Communication in the Era of the 21st Century Cures Act Appendix B. Included Studies Previous Page   Table of Contents Electronic Test Result Communication in the Era of the 21st Century Cures Act Introduction Methods Results Discussion Conclusions References Appe…
  14. www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-test-result-communication3.html
    July 01, 2024 - Electronic Test Result Communication in the Era of the 21st Century Cures Act Methods Previous Page Next Page Table of Contents Electronic Test Result Communication in the Era of the 21st Century Cures Act Introduction Methods Results Discussion Conclusions References Appendix A. Datab…
  15. www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-test-result-communication2.html
    July 01, 2024 - Electronic Test Result Communication in the Era of the 21st Century Cures Act Introduction Previous Page Next Page Table of Contents Electronic Test Result Communication in the Era of the 21st Century Cures Act Introduction Methods Results Discussion Conclusions References Appendix A. …
  16. www.ahrq.gov/sites/default/files/wysiwyg/topics/diagnostic-safety-workgroupmeeting-notes-july2022.pdf.pdf
    November 03, 2022 - Update AHRQ/ Improvement and Patient Safety • Diagnostic Safety Building Contract o Posted our 7th Issue … errors through voluntary event reporting (I- STAR). 2 https://www.ahrq.gov/patient-safety/reports/issue-briefs … /education-dx-outcomes.html https://www.ahrq.gov/patient-safety/reports/issue-briefs/education-dx-outcomes.html … https://www.ahrq.gov/patient-safety/reports/issue-briefs/education-dx-outcomes.html https://www.ahrq.gov
  17. www.ahrq.gov/sites/default/files/2025-05/blocker-report.pdf
    January 01, 2025 - The conference also produced a Special Issue on Resilience Engineering in the Applied Ergonomics journal …  A Special Issue on Resilience Engineering will be published in the Applied Ergonomics journal. … As of July 29, 2019, 13 papers submitted to the special issue were under review. … for newcomers interested in engineering resilience in healthcare”) will be published in the Special Issue … The Special Issue tentative publication date is January 6, 2020.
  18. www.ahrq.gov/diagnostic-safety/resources/issue-briefs/state-of-science-1.html
    June 01, 2020 - In this Issue Brief, we discuss the state of the science of operational measurement of diagnostic safety
  19. www.ahrq.gov/diagnostic-safety/resources/issue-briefs/distributed-cognition-er-nurses1.html
    August 01, 2022 - This issue brief discusses the nurse’s role in diagnostic safety, using the conceptual lens of distributed
  20. www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-pediatric-safety-1.html
    August 01, 2023 - This issue brief explores the unique challenges of studying and improving diagnostic safety for children … The issue brief will also highlight approaches to address these challenges across the care delivery spectrum

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