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psnet.ahrq.gov/node/49501/psn-pdf
February 03, 2006 - Lost in Transition
February 1, 2006
Beach C. Lost in Transition. PSNet [internet]. 2006.
https://psnet.ahrq.gov/web-mm/lost-transition
Case Objectives
Provide an overview of transitions in continuously operating industries
Review cognitive error
Describe the complex dynamics of transitions in emergency care
Pro…
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psnet.ahrq.gov/node/49698/psn-pdf
December 01, 2013 - SNFs: Opening the Black Box
December 1, 2013
Ouslander JG, Bonner A. SNFs: Opening the Black Box. PSNet [internet]. 2013.
https://psnet.ahrq.gov/web-mm/snfs-opening-black-box
The Case
An 88-year-old woman was admitted to a skilled nursing facility (SNF) after a lengthy hospitalization for a
small bowel obstructio…
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psnet.ahrq.gov/node/49660/psn-pdf
August 01, 2012 - No News May Not Be Good News
August 1, 2012
Moore CR. No News May Not Be Good News. PSNet [internet]. 2012.
https://psnet.ahrq.gov/web-mm/no-news-may-not-be-good-news
Case Objectives
Describe the frequency with which ambulatory test results are not followed up by providers.
Appreciate that inadequate follow-up of…
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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…
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psnet.ahrq.gov/web-mm/code-blue-where
March 30, 2020 - Code Blue—Where To?
Citation Text:
Adams BD. Code Blue—Where To?. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2007.
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psnet.ahrq.gov/primer/failure-rescue
September 15, 2024 - Failure to Rescue
Citation Text:
Tokareva I, Romano P. Failure to Rescue. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2025.
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psnet.ahrq.gov/innovation/patient-and-family-centered-i-pass-family-centered-communication-program-reduce-medical
February 26, 2025 - Patient and Family Centered I-PASS (Family-Centered Communication Program to Reduce Medical Errors and Improve Family Experience and Communication Processes)
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psnet.ahrq.gov/web-mm/other-side
May 01, 2007 - SPOTLIGHT CASE
The Other Side
Citation Text:
Vincent CA. The Other Side. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2003.
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www.uspreventiveservicestaskforce.org/uspstf/recommendation/preeclampsia-screening-1996
January 01, 1996 - Share to Facebook
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archived
Final Recommendation Statement
Preeclampsia: Screening
January 01, 1996
Recommendations made by the USPSTF are independent of the U.S. government. They should …
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meps.ahrq.gov/data_files/publications/st491/stat491.shtml
July 01, 2016 - STATISTICAL BRIEF #491:
National Health Care Expenses in the U.S. Civilian Noninstitutionalized Population, Distributions by Type of Service and Source of Payment, 2013
Skip to main content
An official website of t…
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psnet.ahrq.gov/primer/burnout
November 20, 2024 - Burnout
Citation Text:
Yellowlees P, Rea M. Burnout. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2022.
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Do…
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digital.ahrq.gov/program-overview/research-reports/2022-year-review/research-themes-and-findings
January 01, 2022 - Research Themes and Findings
The DHR program funds research that demonstrates how digital healthcare solutions can be designed and implemented to improve healthcare system performance and patient health outcomes. Our funded research focuses on advancing patient safety, care, and shared dec…
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www.uspreventiveservicestaskforce.org/uspstf/recommendation-topics/uspstf-a-and-b-recommendations
June 01, 2025 - Share to Facebook
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A & B Recommendations
A listing of all the Recommendations with a grade of either A or B.
A and B grade recommendations are services that the Task Force most highly recommends implemen…
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cdsic.ahrq.gov/cdsic/workgroup-viewpoint
February 03, 2023 - :
Skip to main content
HHS.gov
Menu
Main navigation
CDS Home
CDS Innovation Collaborative
An official website of the Department of Health & Human Services
…
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www.uspreventiveservicestaskforce.org/uspstf/recommendation/lung-cancer-screening-2004
May 15, 2004 - Share to Facebook
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archived
Final Recommendation Statement
Lung Cancer: Screening, May 2004
May 15, 2004
Recommendations made by the USPSTF are independent of the U.S. government. The…
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digital.ahrq.gov/sites/default/files/docs/page/A_ReferenceLibrary_0.pdf
February 16, 2006 - A_ReferenceLibrary
Appendix A:
Reference Library
APPENDIX A: REFERENCE LIBRARY
PURPOSE: This reference library is intended to provide a focused subset of key papers,
presentations, and other resources to aid r…
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effectivehealthcare.ahrq.gov/sites/default/files/related_files/diagnostic-error-executive-summary.pdf
August 01, 2023 - Comparative Effectiveness Review No. 258_Diagnostic Errors in the Emergency Department: A Systematic Review
Comparative Effectiveness Review
Number 258
Diagnostic Errors in the Emergency
Department: A Systematic Review
Evidence Summary
Main Points
• Overall diagnostic accuracy in the emergen…
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psnet.ahrq.gov/web-mm/breakage-picc-line
June 21, 2023 - SPOTLIGHT CASE
Breakage of a PICC Line
Citation Text:
Dimov V. Breakage of a PICC Line. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2009.
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www.ahrq.gov/sites/default/files/2024-03/connolly-report.pdf
January 01, 2024 - Final Progress Report: Topical Vancomycin for Neurosurgery Wound Prophylaxis
Title: Topical Vancomycin for Neurosurgery Wound Prophylaxis
Principal Investigator: Connolly, Edward Sander
Team Members:
Jared Knopman, MD - Site PI (Cornell)
Emilia Bagiella, PhD - Site PI (Mount Sinai)
Franklin Lowy, MD - Co-Investigato…
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www.ahrq.gov/news/events/nac/2020-03-nac/nacmtg032620-minutes.html
August 01, 2020 - Meeting Minutes, March 2020
National Advisory Council
Minutes from the March 26, 2020, meeting of the Agency for Healthcare Research and Quality's National Advisory Council.
Contents
Summary
Call to Order and Approval of March 26, 2020, Meeting Summary
AHRQ Budget Update and Recent Accomplishments
A…