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psnet.ahrq.gov/issue/overrides-medication-related-clinical-decision-support-alerts-outpatients
September 01, 2016 - The development and piloting of the Ambulatory Electronic Health Record Evaluation Tool: lessons … learned. … The development and piloting of the Ambulatory Electronic Health Record Evaluation Tool: lessons … learned.
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psnet.ahrq.gov/issue/using-estimated-true-safety-event-rates-versus-flagged-safety-event-rates-does-it-change
December 15, 2011 - Partnering with VA stakeholders to develop a comprehensive patient safety data display: lessons … learned from the field. … March 6, 2019
Quality improvement lessons learned from National Implementation of the
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psnet.ahrq.gov/issue/developing-reliable-and-valid-patient-measure-safety-hospitals-pmos-validation-study
January 19, 2014 - February 15, 2017
Lessons learned for reducing the negative impact of adverse events … physician-reviewed malpractice claims from a non-tort, blame-free, national patient insurance system: lessons … learned from Sweden.
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psnet.ahrq.gov/issue/actions-and-implementation-strategies-reduce-suicidal-events-veterans-health-administration
January 05, 2017 - Anesthesia adverse events voluntarily reported in the Veterans Health Administration and lessons … learned. … April 12, 2019
Sharing lessons learned to prevent adverse events in anesthesiology nationwide
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psnet.ahrq.gov/issue/hospital-organisation-management-and-structure-prevention-health-care-associated-infection
January 22, 2014 - May 25, 2011
Lessons learned for reducing the negative impact of adverse events on patients … U.S. compounding pharmacy-related outbreaks, 2001--2013: public health and patient safety lessons … learned.
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psnet.ahrq.gov/issue/suicide-attempts-and-completions-medical-surgical-and-intensive-care-units
June 21, 2017 - July 16, 2015
Sharing lessons learned to prevent incorrect surgery. … Anesthesia adverse events voluntarily reported in the Veterans Health Administration and lessons … learned.
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psnet.ahrq.gov/issue/analysis-adverse-events-rehabilitation-department-using-veterans-affairs-root-cause-analysis
June 21, 2017 - July 16, 2015
Sharing lessons learned to prevent incorrect surgery. … Anesthesia adverse events voluntarily reported in the Veterans Health Administration and lessons … learned.
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psnet.ahrq.gov/issue/how-do-hospitalized-patients-feel-about-resident-work-hours-fatigue-and-discontinuity-care
July 02, 2008 - July 14, 2010
Hospitalists as Emerging Leaders in Patient Safety: lessons learned and … January 29, 2010
Project BOOST implementation: lessons learned.
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psnet.ahrq.gov/issue/applying-high-reliability-health-care-maturity-model-assess-hospital-performance-va-case
December 19, 2014 - Partnering with VA stakeholders to develop a comprehensive patient safety data display: lessons … learned from the field. … January 27, 2019
Quality improvement lessons learned from National Implementation of
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psnet.ahrq.gov/issue/validating-patient-safety-indicators-veterans-health-administration-do-they-accurately
January 18, 2013 - Partnering with VA stakeholders to develop a comprehensive patient safety data display: lessons … learned from the field. … November 10, 2010
Quality improvement lessons learned from National Implementation of
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psnet.ahrq.gov/issue/assessment-incorrect-surgical-procedures-within-and-outside-operating-room-follow-study-us
October 24, 2018 - July 3, 2014
Sharing lessons learned to prevent adverse events in anesthesiology nationwide … July 16, 2015
Sharing lessons learned to prevent incorrect surgery.
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psnet.ahrq.gov/node/36163/psn-pdf
September 29, 2010 - case study shares the experiences of the BTS, the positive impact they had on adverse events, and
lessons … learned that fueled their success. … improving-bar-coded-medication-administration-system-department-veterans-affairs
https://psnet.ahrq.gov/issue/reducing-adverse-drug-events-lessons-breakthrough-series-collaborative
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digital.ahrq.gov/sites/default/files/docs/page/forging-pathway-for-electronic-prescribing-of-controlled-substances.pdf
March 01, 2014 - Findings and Lessons Learned
Dr. … Findings
and lessons learned from the project can inform other
community and State initiatives implementing … The findings and lessons learned from this
research and demonstration project will inform other
community
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psnet.ahrq.gov/node/36067/psn-pdf
September 28, 2010 - describe a postoperative debriefing tool used by surgical teams at Johns Hopkins Hospital and
share lessons … learned since implementation.
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digital.ahrq.gov/sites/default/files/docs/overcoming-barriers-slides-090512.pdf
September 05, 2012 - Learned
66
EPCS Project Collaborators
■ MA Department of Public Health, Drug Control Program … Learned (cont … Learned (cont … Learned
Lessons Learned (cont.) … Lessons Learned (cont.)
Next Steps
Contacts
Q & A
CME/CNE Credits
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psnet.ahrq.gov/issue/using-ahrq-patient-safety-indicators-detect-postdischarge-adverse-events-veterans-health
June 04, 2014 - Partnering with VA stakeholders to develop a comprehensive patient safety data display: lessons … learned from the field. … November 10, 2010
Quality improvement lessons learned from National Implementation of
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psnet.ahrq.gov/issue/systematic-review-patient-safety-measures-adult-primary-care
March 15, 2016 - Partnering with VA stakeholders to develop a comprehensive patient safety data display: lessons … learned from the field. … September 25, 2019
Quality improvement lessons learned from National Implementation of
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psnet.ahrq.gov/issue/effective-interventions-and-implementation-strategies-reduce-adverse-drug-events-veterans
January 02, 2017 - October 21, 2020
Sharing lessons learned to prevent adverse events in anesthesiology … Anesthesia adverse events voluntarily reported in the Veterans Health Administration and lessons … learned.
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psnet.ahrq.gov/issue/impact-vendor-computerized-physician-order-entry-community-hospitals
December 31, 2014 - July 31, 2013
Lessons learned from implementation of computerized provider order entry … February 12, 2014
Lessons learned from implementation of computerized provider order
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psnet.ahrq.gov/node/36421/psn-pdf
August 05, 2008 - //psnet.ahrq.gov/issue/what-pilots-can-teach-hospitals-about-patient-safety
This article discusses lessons … the airline industry has learned about communication, teamwork, and error
reporting and how they might