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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43749/psn-pdf
    December 10, 2014 - Alarm management: first things first: using reliable data to eliminate unnecessary alarms. December 10, 2014 Vanderveen T. Patient Saf Qual Healthc. November/December 2014;11:38-40,42-45. https://psnet.ahrq.gov/issue/alarm-management-first-things-first-using-reliable-data-eliminate-unnecessary- alarms Spotlightin…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/846159/psn-pdf
    March 15, 2023 - Undertaking risk and relational work to manage vulnerability: acute medical patients' involvement in patient safety in the NHS. March 15, 2023 Sutton E, Martin G, Eborall H, et al. Undertaking risk and relational work to manage vulnerability: acute medical patients’ involvement in patient safety in the NHS. Soc Sc…
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42674/psn-pdf
    September 12, 2016 - Using crew resource management and a 'read-and-do checklist' to reduce failure-to-rescue events on a step- down unit. September 12, 2016 Young-Xu Y, Fore AM, Metcalf A, et al. Using crew resource management and a 'read-and-do checklist' to reduce failure-to-rescue events on a step-down unit. Am J Nurs. 2013;113(9)…
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60804/psn-pdf
    August 12, 2020 - Improved medication management with introduction of a perioperative and prescribing pharmacist service. August 12, 2020 Nguyen AD, Lam A, Banakh I, et al. Improved medication management with introduction of a perioperative and prescribing pharmacist service. J Pharm Pract. 2020;33(3):299-305. doi:10.1177/0897190018…
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/37805/psn-pdf
    February 15, 2011 - Designing and implementing a comprehensive quality and patient safety management model: a paradigm for perioperative improvement. February 15, 2011 Herzer KR, Mark LJ, Michelson JD, et al. Designing and Implementing a Comprehensive Quality and Patient Safety Management Model. J Patient Saf. 2008;4(2). doi:10.1097/…
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41207/psn-pdf
    September 27, 2016 - Improving patient safety and optimizing nursing teamwork using crew resource management techniques. September 27, 2016 West P, Sculli GL, Fore AM, et al. Improving patient safety and optimizing nursing teamwork using crew resource management techniques. J Nurs Adm. 2012;42(1):15-20. doi:10.1097/NNA.0b013e31823c17c7…
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/36463/psn-pdf
    July 10, 2008 - Missed opportunities in the primary care management of early acute ischemic heart disease. July 10, 2008 Sequist TD, Marshall R, Lampert S, et al. Missed opportunities in the primary care management of early acute ischemic heart disease. Arch Intern Med. 2006;166(20):2237-43. https://psnet.ahrq.gov/issue/missed-op…
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41117/psn-pdf
    March 04, 2015 - The effectiveness of integrated health information technologies across the phases of medication management: a systematic review of randomized controlled trials. March 4, 2015 McKibbon A, Lokker C, Handler S, et al. The effectiveness of integrated health information technologies across the phases of medication man…
  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/41894/psn-pdf
    January 01, 2016 - Simulator-based crew resource management training for interhospital transfer of critically ill patients by a mobile ICU. January 9, 2013 Droogh JM, Kruger HL, Ligtenberg JJM, et al. Simulator-Based Crew Resource Management Training for Interhospital Transfer of Critically Ill Patients by a Mobile ICU. Jt Comm J Qu…
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/47775/psn-pdf
    April 03, 2019 - Reducing diagnostic errors worldwide through diagnostic management teams. April 3, 2019 Verna R, Velazquez AB, Laposata M. Reducing Diagnostic Errors Worldwide Through Diagnostic Management Teams. Ann Lab Med. 2019;39(2):121-124. doi:10.3343/alm.2019.39.2.121. https://psnet.ahrq.gov/issue/reducing-diagnostic-error…
  11. psnet.ahrq.gov/issue/operating-management-system-high-reliability-leadership-accountability-learning-and
    July 01, 2016 - Commentary Operating management system for high reliability: leadership, accountability, learning and innovation in healthcare. Citation Text: Day RM, Demski RJ, Pronovost PJ, et al. Operating management system for high reliability: Leadership, accountability, learning and innovation in …
  12. effectivehealthcare.ahrq.gov/sites/default/files/pdf/TND_0319_06-17-2009.pdf
    January 01, 2009 - Effective Health Care Topic Number(s): 0170 Document Completion Date: 1-13-10 1 Results of Topic Selection Process & Next Steps  The use of procalcitonin for the diagnosis and management of sepsis will go forward for refinement as a systematic review. The scope of this topic, including popul…
  13. psnet.ahrq.gov/issue/deploying-and-measuring-risk-and-patient-safety-program
    January 19, 2022 - Commentary Deploying and measuring a risk and patient safety program. Citation Text: Orel H, McGroarty M, Marchegiani H. Deploying and measuring a risk and patient safety program. J Healthc Risk Manag. 2017;36(3):26-33. doi:10.1002/jhrm.21266. Copy Citation Format: DOI Goog…
  14. digital.ahrq.gov/ahrq-funded-projects/enabling-health-care-decisionmaking-through-use-health-information-technology/annual-summary/2010
    January 01, 2010 - Enabling Health Care Decisionmaking through the Use of Health Information Technology - 2010 Project Name Enabling Health Care Decisionmaking through the Use of Health Information Technology Principal Investigator Lobach, David Organization Duke University Contract Num…
  15. psnet.ahrq.gov/issue/matching-nurse-skill-patient-acuity-intensive-care-units-risk-management-mandate
    April 24, 2018 - Commentary Matching nurse skill with patient acuity in the intensive care units: a risk management mandate. Citation Text: Rischbieth A. Matching nurse skill with patient acuity in the intensive care units: a risk management mandate. J Nurs Manag. 2006;14(5):397-404. Copy Citation …
  16. psnet.ahrq.gov/issue/clinical-risk-management-and-patient-safety-education-nurses-critique
    June 22, 2009 - Commentary Clinical risk management and patient safety education for nurses: a critique. Citation Text: Johnstone M-J, Kanitsaki O. Clinical risk management and patient safety education for nurses: a critique. Nurse Educ Today. 2007;27(3):185-91. Copy Citation Format: Goo…
  17. www.ahrq.gov/sites/default/files/wysiwyg/cahps/news-and-events/events/20140115_DB/3_Deborah_Kilstein_slides_29-40.pdf
    January 15, 2014 - Using the CAHPS Database to Compare, Report, and Improve Organizational Performance CAHPS Sponsor Report The ACAP Experience Deborah Kilstein ACAP Vice President, Quality Management and Operational Support January 15, 2014 29 Agenda      30 Who is ACAP? Growing role of health plans What …
  18. effectivehealthcare.ahrq.gov/sites/default/files/pdf/TND_0715-140408.pdf
    May 29, 2025 - Topic 0590 Strategies to Treat and Manage Infantile Hemangioma NSD FINAL_SJ Strategies to Treat and Manage Infantile Hemangioma Nomination Summary Document …
  19. psnet.ahrq.gov/issue/pain-management-and-prescription-opioid-related-harms-exploring-state-evidence-proceedings
    July 05, 2008 - Meeting/Conference Proceedings Pain Management and Prescription Opioid-related Harms: Exploring the State of the Evidence: Proceedings of a Workshop—in Brief. Citation Text: Pain Management and Prescription Opioid-related Harms: Exploring the State of the Evidence: Proceedings of a Works…
  20. psnet.ahrq.gov/sites/default/files/2022-02/final_cme_reviewed_spotlight_loss_of_trust_and_a_missed_diagnosis_02.14.20221_-_clean_-_revised.pdf
    January 01, 2022 - Microsoft PowerPoint - FINAL CME Reviewed Spotlight_Loss of Trust and a Missed Diagnosis_02.14.20221 - clean - REVISED.pptx Spotlight A Loss of Trust and a Missed Diagnosis Source and Credits • This presentation is based on the February 2022 AHRQ WebM&M Spotlight Case o See the full article at https://psnet.ahrq.…