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  1. digital.ahrq.gov/sites/default/files/docs/publication/r13hs021022-agarwal-final-report-2013.pdf
    January 01, 2013 - 2011 – 2013 Workshop on Health IT & Economics (WHITE) - Final Report Grant Final Report Grant ID: 1R13HS021022 2011 – 2013 Workshop on Health IT & Economics (WHITE) Inclusive Dates: 09/01/11 – 11/30/13 Principal Investigator: Ritu Agarwal, PhD Team Members: Guodong Gao, PhD Jeffrey M…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60745/psn-pdf
    October 01, 2020 - Multiple High-Risk Events Involving Workflow for Wasting of Medications Used by Anesthesia July 29, 2020 Nguyen DD, Harper TA, Cello R. Multiple High-Risk Events Involving Workflow for Wasting of Medications Used by Anesthesia. PSNet [internet]. 2020. https://psnet.ahrq.gov/web-mm/multiple-high-risk-events-involvi…
  3. www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa/170-cusp-science-safety-notes.docx
    October 01, 2024 - Including members from different roles and all relevant stakeholder groups leads to a better understanding
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/867497/psn-pdf
    February 26, 2025 - sponge because they thought the sponge radiopaque markers were just wires from electrode monitoring leads
  5. www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/qdr-data-spotlight-heart-failure-hospital.pdf
    July 01, 2023 - Hospital Deaths for Common Heart Conditions Increased While Hospitalizations Decreased During the First Year of COVID-19 1 Hospital Deaths for Common Heart Conditions Increased While Hospitalizations Decreased During the First Year of COVID-19 Deaths From Heart Disease Increased in 2020 Heart disease is the mo…
  6. psnet.ahrq.gov/web-mm/acute-respiratory-arrest-pregnancy
    August 15, 2018 - WebM&M Cases Uterine Artery Injury during Cesarean Delivery Leads
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49475/psn-pdf
    March 01, 2005 - as instances of human ("operator") error.(12,13) The view that technology is relatively infallible leads
  8. psnet.ahrq.gov/web-mm/unexpected-drawbacks-electronic-order-sets
    December 01, 2017 - October 1, 2016 WebM&M Cases Lapse in Antibiotics Leads
  9. psnet.ahrq.gov/web-mm/infused-not-ingested
    February 01, 2017 - In practice, this tension is exactly what leads to cases such as the one presented here.
  10. psnet.ahrq.gov/web-mm/overdose-gabapentin-and-oxycodone-patient-end-stage-renal-disease-case-appropriate
    October 31, 2023 - Configuring drug-disease alerts in EHRs is complex, as available software often leads to excessive unimportant
  11. www.ahrq.gov/patient-safety/settings/hospital/resource/pressureinjury/guide/apd.html
    October 01, 2017 - Pressure Injury Prevention Program Implementation Guide Appendix D. Sample Production Agenda for the In-Person Training Previous Page Next Page Table of Contents Pressure Injury Prevention Program Implementation Guide Overview Get Ready Pressure Injury Prevention Program Phases Appendix A. R…
  12. www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/strategy2/Strat2_Tool_5_Comm_Comp_508.docx
    June 02, 2025 - Strategy 2: Communicating for Improve Quality (Tool 5) Overview of Communication Competencies Effective communication between clinicians, patients, and families can lead to better health care outcomes and improved quality and safety. The following list identifies behaviors to help clinicians build partnerships with pa…
  13. www.ahrq.gov/prevention/resources/chronic-care/clinical-community-relationships-measures-atlas/ccrm-atlasrefs.html
    July 01, 2018 - Clinical-Community Relationships Measures (CCRM) Atlas References Previous Page Next Page Table of Contents Clinical-Community Relationships Measures (CCRM) Atlas Introduction Acknowledgments 1. Why Was the Clinical-Community Relationships Measures Atlas Developed? 2. What Is a Clinical-Comm…
  14. www.ahrq.gov/sites/default/files/wysiwyg/evidencenow/results/research/recruitment-packet-va.pdf
    October 01, 2015 - Heart of Virginia Healthcare Heart of Virginia Healthcare Restoring the joy in primary care. I :7 • Heart of Virginia Healthcare is one of seven cooperatives in the country funded by the Agency for Healthcare Research and Quality’s EvidenceNow initiative. Of…
  15. www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-ehr-impact5.html
    July 01, 2024 - Documenting Diagnosis: Exploring the Impact of Electronic Health Records on Diagnostic Safety The Future of Diagnostic Documentation Previous Page Next Page Table of Contents Documenting Diagnosis: Exploring the Impact of Electronic Health Records on Diagnostic Safety Introduction on Diagnostic Do…
  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73902/psn-pdf
    September 29, 2021 - sources, as well as bacteremia of unknown origin.2 The purulent fluid collection associated with SEA leads
  17. psnet.ahrq.gov/perspective/patient-safety-office-based-care-settings
    January 31, 2024 - And that lack leads to risks and quality and safety gaps.
  18. psnet.ahrq.gov/perspective/reducing-safety-hazards-monitor-alert-and-alarm-fatigue
    May 01, 2016 - artifacts can cause alarms highlighting system malfunctions (called technical alarms; an example is a "leads
  19. cds.ahrq.gov/sites/default/files/cds/artifact/476/CDS%20Pain%20Management%20Summary%20Quick%20Start%20Guide_final_1.pdf
    July 23, 2024 - CDS Repository Working Group Charter CDS Pain Management Summary Quick Start Guide The Pain Management Summary displays relevant patient-centered data to inform pain management decisions. It includes concepts outlined in the CDC Guideline for Prescribing Opioids for Chronic Pain. To View the Pain Man…
  20. psnet.ahrq.gov/issue/fda-alerts-health-care-providers-compounders-and-patients-dosing-errors-associated-compounded
    February 15, 2024 - Press Release/Announcement FDA alerts health care providers, compounders and patients of dosing errors associated with compounded injectable semaglutide products. Citation Text: FDA alerts health care providers, compounders and patients of dosing errors associated with compounded injecta…