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psnet.ahrq.gov/issue/individual-surgeon-mortality-rates-can-outliers-be-detected-national-utility-analysis
October 27, 2021 - Study
Individual surgeon mortality rates: can outliers be detected? A national utility analysis.
Citation Text:
Harrison EM, Drake TM, O'Neill S, et al. Individual surgeon mortality rates: can outliers be detected? A national utility analysis. BMJ Open. 2016;6(10):e012471. doi:10.1136/bm…
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psnet.ahrq.gov/issue/systematic-review-evidence-links-between-patient-experience-and-clinical-safety-and
May 01, 2019 - Review
A systematic review of evidence on the links between patient experience and clinical safety and effectiveness.
Citation Text:
Doyle C, Lennox L, Bell D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open. 2013;…
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psnet.ahrq.gov/issue/out-hospital-medication-errors-among-young-children-united-states-2002-2012
June 14, 2017 - Study
Out-of-hospital medication errors among young children in the United States, 2002–2012.
Citation Text:
Smith MD, Spiller HA, Casavant MJ, et al. Out-of-hospital medication errors among young children in the United States, 2002-2012. Pediatrics. 2014;134(5):867-76. doi:10.1542/peds.…
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psnet.ahrq.gov/issue/patient-outcomes-after-introduction-statewide-icu-nurse-staffing-regulations
June 19, 2019 - Study
Patient outcomes after the introduction of statewide ICU nurse staffing regulations.
Citation Text:
Law AC, Stevens JP, Hohmann S, et al. Patient Outcomes After the Introduction of Statewide ICU Nurse Staffing Regulations. Crit Care Med. 2018;46(10):1563-1569. doi:10.1097/CCM.00000…
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psnet.ahrq.gov/issue/intervention-study-reduction-medication-errors-elderly-trauma-patients
December 18, 2019 - Study
Intervention study for the reduction of medication errors in elderly trauma patients.
Citation Text:
Parro Martín M de los Á, Muñoz García M, Delgado Silveira E, et al. Intervention study for the reduction of medication errors in elderly trauma patients. J Eval Clin Pract. 2021;27(…
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psnet.ahrq.gov/issue/patient-safety-indicators-england-hospital-administrative-data-case-control-analysis-and
June 15, 2011 - Study
Patient safety indicators for England from hospital administrative data: case-control analysis and comparison with US data.
Citation Text:
Raleigh VS, Cooper J, Bremner SA, et al. Patient safety indicators for England from hospital administrative data: case-control analysis and c…
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psnet.ahrq.gov/issue/hospital-leadership-and-quality-improvement-rhetoric-versus-reality
May 07, 2014 - Study
Hospital leadership and quality improvement: rhetoric versus reality.
Citation Text:
Levey S, Vaughn T, Koepke M, et al. Hospital Leadership and Quality Improvement. J Patient Saf. 2008;3(1). doi:10.1097/pts.0b013e3180311256.
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psnet.ahrq.gov/issue/patient-physician-medical-assistant-and-office-visit-factors-associated-medication-list
June 28, 2017 - Study
Patient, physician, medical assistant, and office visit factors associated with medication list agreement.
Citation Text:
Reedy AB, Yeh JY, Nowacki AS, et al. Patient, Physician, Medical Assistant, and Office Visit Factors Associated With Medication List Agreement. J Patient Saf. 2…
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psnet.ahrq.gov/issue/potentially-inappropriate-medication-use-among-elderly-home-care-patients-europe
September 19, 2016 - Study
Potentially inappropriate medication use among elderly home care patients in Europe.
Citation Text:
Fialová D, Topinková E, Gambassi G, et al. Potentially inappropriate medication use among elderly home care patients in Europe. JAMA. 2005;293(11):1348-58.
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psnet.ahrq.gov/issue/three-scans-are-better-two-follow-automatic-method-finding-missed-and-misidentified-lesions
August 17, 2022 - Study
Three scans are better than two for follow-up: an automatic method for finding missed and misidentified lesions in cross-sectional follow-up of oncology patients.
Citation Text:
Joskowicz L, Di Veroli B, Lederman R, et al. Three scans are better than two for follow-up: an automatic…
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psnet.ahrq.gov/issue/unscheduled-returns-emergency-department-outcome-medical-errors
November 12, 2014 - Study
Unscheduled returns to the emergency department: an outcome of medical errors?
Citation Text:
Nuñez S, Hexdall A, Aguirre-Jaime A. Unscheduled returns to the emergency department: an outcome of medical errors? Qual Saf Health Care. 2006;15(2):102-8.
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psnet.ahrq.gov/issue/identifying-hospital-wide-harm-set-icd-9-cm-coded-conditions-associated-increased-cost-length
September 07, 2016 - Study
Identifying hospital-wide harm: a set of ICD-9–CM-coded conditions associated with increased cost, length of stay, and risk of mortality.
Citation Text:
Bankowitz RA, Doyle B, Duan M, et al. Identifying hospital-wide harm: a set of ICD-9-CM-coded conditions associated with increase…
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www.ahrq.gov/teamstepps-program/evidence-base/labor.html
May 01, 2023 - TeamSTEPPS Research/Evidence Base: Labor and Delivery
Block M., Ehrenworth J. F., et al. (2013). Measuring handoff quality in labor and delivery: Development, validation, and application of the Coordination of Handoff Effectiveness Questionnaire (CHEQ). Joint Commission Journal on Quality and Patient Safety 3…
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psnet.ahrq.gov/issue/assessing-relationship-between-patient-safety-culture-and-ehr-strategy
December 21, 2018 - Study
Assessing the relationship between patient safety culture and EHR strategy.
Citation Text:
Ford E, Silvera GA, Kazley AS, et al. Assessing the relationship between patient safety culture and EHR strategy. Int J Health Care Qual Assur. 2016;29(6):614-27. doi:10.1108/IJHCQA-10-2015-0…
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www.ahrq.gov/policymakers/chipra/demoeval/demostates/wy.html
March 01, 2019 - State at a Glance: Wyoming
Learn more about the CHIPRA quality demonstration projects being implemented in Wyoming.
Wyoming is featured in the following reports from the National Evaluation:
Evaluation Highlight No. 6 : How are CHIPRA quality demonstration States working together to improve the quality …
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psnet.ahrq.gov/issue/patient-and-carer-identified-factors-which-contribute-safety-incidents-primary-care
March 18, 2016 - Study
Patient and carer identified factors which contribute to safety incidents in primary care: a qualitative study.
Citation Text:
Hernan AL, Giles SJ, Fuller J, et al. Patient and carer identified factors which contribute to safety incidents in primary care: a qualitative study. BMJ Q…
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psnet.ahrq.gov/issue/do-patient-safety-events-increase-readmissions
November 04, 2015 - Study
Do patient safety events increase readmissions?
Citation Text:
Friedman B, Encinosa W, Jiang J, et al. Do patient safety events increase readmissions? Med Care. 2009;47(5):583-90. doi:10.1097/MLR.0b013e31819434da.
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psnet.ahrq.gov/issue/patient-safety-palliative-care-mixed-methods-study-reports-national-database-serious
May 16, 2018 - Study
Emerging Classic
Patient safety in palliative care: a mixed-methods study of reports to a national database of serious incidents.
Citation Text:
Yardley I, Yardley S, Williams H, et al. Patient safety in palliative care: A mixed-methods study of reports to…
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psnet.ahrq.gov/issue/culture-openness-associated-lower-mortality-rates-among-137-english-national-health-service
September 20, 2012 - Study
A culture of openness is associated with lower mortality rates among 137 English National Health Service acute trusts.
Citation Text:
Toffolutti V, Stuckler D. A Culture Of Openness Is Associated With Lower Mortality Rates Among 137 English National Health Service Acute Trusts. Hea…
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www.ahrq.gov/news/newsroom/case-studies/ktcquips99.html
October 01, 2014 - New York Hospitals Use AHRQ Toolkit to Revise Protocol for Preventing Blood Clots
Search All Impact Case Studies
May 2012
Seven New York hospitals revised their protocol for preventing venous thromboembolism (VTE) after their State Quality Improvement Organization (QIO), IPRO, participated in a series of on…