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3101. INSTRUCTIONS: Return on Investment Estimation (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/f1-returnoninvestment.pdf
      January 01, 2009 - For example, reduction in adverse events can lead to reduced length of stay, which may affect finances

3102. A Patient Safety Program & Research Evaluation of U.S. Navy Pharmacy Refill Clinics (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol1/Reige.pdf
      March 01, 2004 - this is paramount for patient care as, for example, long-term high cholesterol and hypertension can lead

3103. Return on Investment Tool (doc file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/f1_combo_returnoninvestment.docx
      January 01, 2013 - For example, reduction in adverse events can lead to reduced length of stay, which may affect finances

3104. Voluntary Hospital Coalitions to Promote Patient Safety (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol3/Rask.pdf
      January 01, 2004 - small successive steps that incorporate learning and making adjustments at each juncture not only can lead

3105. SimCare: A Model for Studying Physician Decisionmaking Activity (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol4/Dutta.pdf
      January 01, 2003 - This may lead to recognition by individual physicians of inefficient patterns of resource use in diabetes

3106. The San Diego Center for Patient Safety: Creating a Research, Education, and Community Consortium (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol4/Pratt.pdf
      March 01, 2004 - The lists of triggers that lead to medication error events were received and compared across Consortium

3107. Systems Change: Treating Tobacco Use and Dependence | Agency for Healthcare Research and Quality
      www.ahrq.gov/prevention/guidelines/tobacco/decisionmakers/systems/index.html
      December 01, 2012 - of public health significance because of evidence that the provision of treatment has been shown to lead

3108. Continuous Respiratory Monitoring and a “Smart” Infusion System Improve Safety of Patient-Controlled Analgesia in the Postoperative Period (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol4/Advances-Maddox_111.pdf
      June 18, 2008 - Numerous factors can lead to opioid-related RD: prescribing errors, PCA pump programming errors, “PCA

3109. AHRQ Safety Program for MRSA Prevention
      www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa/029-hand-hygiene-webinar-slides.pptx
      October 01, 2024 - Non-ICU Hand Hygiene Promotion 37 Evaluate: Data Analysis and Sharing2,27-29 Hand Hygiene Program Lead

3110. Optimizing Environmental Cleaning: Webinar Slide Presentation
      www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa/021-optimizing-evc-webinar-slides_revised.pptx
      October 01, 2024 - Even if suboptimal cleaning did not cause the increase in C. difficile, “colonization pressure” may lead

3111. Final Progress Report: The Effect of EMR on Medication Safety: A SPUR-Net Study (pdf file)
      www.ahrq.gov/sites/default/files/2024-01/kuo-report.pdf
      January 01, 2024 - defines a "medication error" as follows: "A medication error is any preventable event that may cause or lead

3112. PowerPoint Presentation: Learn From Defects for Sustainability
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/modules/sustainability/sustainability_learn_from_defects.pptx
      December 01, 2017 - ASK: How do all these pieces lead to this error or the event that occurred?

3113. Appendix: State Overviews (continued) | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/medicaidmgmt/tap2.html
      October 01, 2014 - The nurse care managers lead a care team that can include the patient's primary care provider, social

3114. References | Agency for Healthcare Research and Quality
      www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-pediatric-safety-refs.html
      August 01, 2023 - Safety Culture, Health Information Technology Implementation, and Medical Office Problems That Could Lead

3115. The Contribution of Diagnostic Errors to Maternal Morbidity and Mortality During and Immediately After Childbirth: State of the Science (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/reports/issue-briefs/dxsafety-issuebrief-maternal-morbidity.pdf
      September 01, 2021 - The case demonstrates how deficiencies in multiple dimensions of the diagnostic process can lead to

3116. Toolkit for the System Approach to Tracking and Increasing Screening for Public Health Improvement of Colorectal Cancer Intervention (pdf file)
      www.ahrq.gov/sites/default/files/publications/files/crctoolkit.pdf
      December 01, 2010 - transferable to health care system settings with a central entity that:  Is motivated to take the lead

3117. Toolkit for the System Approach to Tracking and Increasing Screening for Public Health Improvement of Colorectal Cancer Intervention (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/research/findings/final-reports/crctoolkit/crctoolkit.pdf
      December 01, 2010 - transferable to health care system settings with a central entity that:  Is motivated to take the lead

3118. Final Progress Report: Reducing Adverse Drug Events From Anticoagulants, Diabetes Agents and Opioids in Primary Care (pdf file)
      www.ahrq.gov/sites/default/files/2024-01/wessell2-report.pdf
      January 01, 2024 - Final Progress Report: Reducing Adverse Drug Events From Anticoagulants, Diabetes Agents and Opioids in Primary Care Final Progress Report Reducing Adverse Drug Events from Anticoagulants, Diabetes Agents and Opioids in Primary Care Principal Investigator: Andrea M. Wessell, PharmD Team Members: Steven M. Orns…

3119. How are CHIPRA Quality Demonstration States working to improve adolescent health care? | Agency for Healthcare Research and Quality
      www.ahrq.gov/policymakers/chipra/demoeval/what-we-learned/highlight03.html
      August 01, 2013 - How are CHIPRA Quality Demonstration States working to improve adolescent health care? Evaluation Highlight No. 3 Authors: Rachel Burton, Ian Hill, and Kelly Devers Contents Key Messages Background Findings Conclusions Implications Learn More Endnotes The CHIPRA Quality Demonstra…

3120. How are CHIPRA quality demonstration States using quality reports to drive heatlh care improvements for children? Evaluation Highlight No. 11 (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/demoeval/what-we-learned/highlight11.pdf
      September 08, 2015 - How are CHIPRA quality demonstration States using quality reports to drive heatlh care improvements for children? Evaluation Highlight No. 11 The CHIPRA Quality Demonstration Grant Program In February 2010, the Centers for Medicare & Medicaid Services (CMS) awarded 10 grants, funding 18 States, to improve the qu…