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digital.ahrq.gov/technology/medication-management-system
January 01, 2025 - Redesign
Identifying electronic medication administration record (eMAR) usability issues … Identifying electronic medication administration record (eMAR) usability issues from patient safety event … Identifying health information technology usability issues contributing to medication errors across medication … Use of EHR Technology
A mixed-method study of practitioners' perspectives on issues … A mixed-method study of practitioners' perspectives on issues related to EHR medication reconciliation
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psnet.ahrq.gov/node/38137/psn-pdf
October 15, 2008 - Ethical and legal issues in the use of health information
technology to improve patient safety. … Ethical and legal issues in the use of health information technology to improve patient safety. … https://psnet.ahrq.gov/issue/ethical-and-legal-issues-use-health-information-technology-improve-patient … -
safety
This review explores the emerging privacy, security, and regulatory issues in using health … https://psnet.ahrq.gov/issue/ethical-and-legal-issues-use-health-information-technology-improve-patient-safety
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psnet.ahrq.gov/issue/how-communications-issues-between-doctors-and-nurses-can-affect-your-health
September 28, 2016 - Newspaper/Magazine Article
How communications issues between doctors and nurses can … Citation Text:
How communications issues between doctors and nurses can affect your health. … URL
Cite
Citation
Citation Text:
How communications issues … October 1, 2016
Costly issues of an uncommunicative OR.
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www.ahrq.gov/patient-safety/reports/engage/results.html
March 01, 2017 - Few identified the health care system (e.g., issues associated with fragmentation of care or continuity … of care between acute and primary care settings) and community (e.g., issues associated with community … Table 5 provides a summary of each domain and the informant-identified safety issues within that domain … guidelines, and other empirical studies that addressed critical issues in the intersection of patient … ; Table 8 ), fragmentation issues (75.3%), diagnostic errors (39.3%), and issues around medications
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www.ahrq.gov/hai/cusp/modules/identify/alt-text.html
March 01, 2013 - Slide 2
CUSP and Sensemaking Tools
CUSP Tools
Staff Safety Assessment
Safety Issues Worksheet … CUSP uses the Staff Safety Assessment and Status of Safety Issues Worksheet to identify defects. … Engage the senior executive in addressing the safety issues identified on the form.
Step 2. … Image of Safety Issues Worksheet for Senior Executive Partnership with three arrows pointing at it. … Engage the senior executive in addressing the safety issues identified on the form.
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www.ahrq.gov/hai/tools/surgery/modules/implementation/audit-briefing-slides.html
December 01, 2017 - What issues were raised? … Access issues - 20% Yes.
Airway risk - 20% Yes.
Beta blockers - 40% Yes. … Safety issues.
Followup:
Met with clinic staff and surgeons. … Issues identified:
Disposable light handles were changed. … Issues identified:
Outdated preference card caused delay in case.
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psnet.ahrq.gov/node/36337/psn-pdf
October 26, 2010 - Technology, governance and patient safety: systems
issues in technology and patient safety. … Technology, governance and patient safety: systems
issues in technology and patient safety. … https://psnet.ahrq.gov/issue/technology-governance-and-patient-safety-systems-issues-technology-and- … adverse events related to medical devices, equipment, and other
technologies and discuss governance issues … https://psnet.ahrq.gov/issue/technology-governance-and-patient-safety-systems-issues-technology-and-patient-safety
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psnet.ahrq.gov/node/40251/psn-pdf
June 13, 2012 - Emerging issues and challenges for improving patient
safety in mental health: a qualitative analysis … Emerging issues and challenges for improving patient safety in mental health: a
qualitative analysis … https://psnet.ahrq.gov/issue/emerging-issues-and-challenges-improving-patient-safety-mental-health- … This article describes the dominant
issues and priorities for improving patient safety in this field … https://psnet.ahrq.gov/issue/emerging-issues-and-challenges-improving-patient-safety-mental-health-qualitative-analysis
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/strategies/labor-delivery-unit/tool_safe-csection.docx
May 01, 2017 - (Each team member listed below either says “Yes” and states the issues or says “No Concerns” if none) … (Each team member listed below either says “Yes” and states the issues or says “No Concerns” if none) … equipment/systems issues identified should be recorded and provided to designated person so they can … be addressed and resolution shared with the unit
Postoperative concerns/issues for the team to be … (Each team member listed below either says “Yes” and states the issues or says “No Concerns” if none.
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psnet.ahrq.gov/issue/nursing-bedside-clinical-handover-integrated-review-issues-and-tools
July 07, 2021 - Review
Nursing bedside clinical handover—an integrated review of issues and tools … Nursing bedside clinical handover - an integrated review of issues and tools. … Nursing bedside clinical handover - an integrated review of issues and tools.
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psnet.ahrq.gov/issue/err-human-quality-and-safety-issues-spine-care
August 04, 2021 - Commentary
To err is human: quality and safety issues in spine care. … To err is human: quality and safety issues in spine care. … To err is human: quality and safety issues in spine care.
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www.ahrq.gov/policymakers/chipra/demoeval/what-we-learned/highlight04.html
October 01, 2013 - Oregon—and how they used their CHIPRA quality demonstration grants to elevate children’s health care issues … helpful to other States that are trying to focus attention and resources on child and adolescent health issues … data can be used to obtain buy-in from policy officials, help raise awareness about pediatric health issues … Demonstration staff have pursued a range of strategies to ensure that child and adolescent health issues … is working to improve quality and reduce the costs of care for youth with serious behavioral health issues
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psnet.ahrq.gov/node/42935/psn-pdf
February 12, 2014 - Socio-technical issues and challenges in implementing
safe patient handovers: insights from ethnographic … Socio-technical issues and challenges in implementing safe patient
handovers: insights from ethnographic … https://psnet.ahrq.gov/issue/socio-technical-issues-and-challenges-implementing-safe-patient-handovers … These analyses emphasize numerous contextual issues that need be
considered when creating computerized … https://psnet.ahrq.gov/issue/socio-technical-issues-and-challenges-implementing-safe-patient-handovers-insights
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psnet.ahrq.gov/node/45132/psn-pdf
July 20, 2016 - Staying silent about safety issues: conceptualizing and
measuring safety silence motives. … Staying silent about safety issues: Conceptualizing and measuring safety
silence motives. … https://psnet.ahrq.gov/issue/staying-silent-about-safety-issues-conceptualizing-and-measuring-safety- … This study found several motives explaining why employees stay silent about safety issues, including … https://psnet.ahrq.gov/issue/staying-silent-about-safety-issues-conceptualizing-and-measuring-safety-silence-motives
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psnet.ahrq.gov/node/74249/psn-pdf
January 12, 2022 - Medication safety issues with newly authorized
PAXLOVID. … https://psnet.ahrq.gov/issue/medication-safety-issues-newly-authorized-paxlovid
Emerging care practices … https://psnet.ahrq.gov/issue/medication-safety-issues-newly-authorized-paxlovid
https://psnet.ahrq.gov
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psnet.ahrq.gov/issue/hearing-patient-safety-and-quality-issues-end-stage-renal-disease-treatment
December 23, 2012 - Congressional Testimony
Hearing on Patient Safety and Quality Issues in End Stage … Citation Text:
Hearing on Patient Safety and Quality Issues in End Stage Renal Disease Treatment. … Cite
Citation
Citation Text:
Hearing on Patient Safety and Quality Issues … Related Resources From the Same Author(s)
Oversight Hearing on Recent Patient Safety Issues
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psnet.ahrq.gov/issue/saying-sorry-some-strategies-effective-apology-within-workplace
August 11, 2021 - Issues Ment Health Nurs. 2018;39(11):980-982. doi:10.1080/01612840.2018.1507571. … Issues Ment Health Nurs . 2018; 39 (11) :980-982 . … Issues Ment Health Nurs. 2018;39(11):980-982. doi:10.1080/01612840.2018.1507571. … August 11, 2021
Ethical issues in patient safety research: a systematic review of the … September 29, 2017
Health professionals' perspectives of safety issues in mental health
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digital.ahrq.gov/ahrq-funded-projects/past-initiatives/medicaid-and-chip
January 01, 2023 - platforms for Medicaid and CHIP staff to use for exchanging up-to-date information on health IT and HIE issues … and to share their questions and experiences related to those issues. … Privacy and Security
Sustainability and Funding
Use of Health IT for Children (CHIP and Children’s Issues … Medicaid or CHIP agency staff person interested in participating in a CoP around other Health IT and HIE issues … Repository
The Medicaid and CHIP repository allows users to search for content on health IT and HIE issues
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psnet.ahrq.gov/node/864377/psn-pdf
March 13, 2024 - patients-experiences-dental-diagnostic-failures-qualitative-study-using-social-
media
Patient safety issues … Participants identified several categories of contributing factors, including clinician issues (e.g., … poor
communication), patient issues (e.g., lack of self-advocacy), and system factors (e.g., insurance
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psnet.ahrq.gov/node/860731/psn-pdf
January 17, 2024 - occupational-health-and-organizational-culture-within-healthcare-setting-
challenges
Healthcare must address workforce issues … This book
is a compiled set of pre-published articles that examine issues of workforce safety and culture … naming-baby-or-beast-importance-concepts-and-labels-healthcare-safety-investigation
https://psnet.ahrq.gov/issue/issues-and-complexities-safety-culture-assessment-healthcare