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psnet.ahrq.gov/issue/health-system-redesign-cardiac-monitoring-oversight-optimize-alarm-management-safety-and
February 15, 2023 - Study
Health system redesign of cardiac monitoring oversight to optimize alarm management, safety, and staff engagement.
Citation Text:
Engel JR, Lindsay M, O'Brien S, et al. Health system redesign of cardiac monitoring oversight to optimize alarm management, safety, and staff engagement…
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psnet.ahrq.gov/issue/use-electronic-decision-support-tool-reduce-polypharmacy-elderly-people-chronic-diseases
August 18, 2021 - Study
Emerging Classic
Use of an electronic decision support tool to reduce polypharmacy in elderly people with chronic diseases: cluster randomised controlled trial.
Citation Text:
Rieckert A, Reeves D, Altiner A, et al. Use of an electronic decision support to…
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psnet.ahrq.gov/issue/hospitalization-due-adverse-drug-events-older-adults-cancer-retrospective-analysis
May 17, 2017 - Study
Hospitalization due to adverse drug events in older adults with cancer: a retrospective analysis.
Citation Text:
Walsh DJ, Sahm LJ, O'Driscoll M, et al. Hospitalization due to adverse drug events in older adults with cancer: a retrospective analysis. J Geriatr Oncol. 2023;14(6):101…
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psnet.ahrq.gov/issue/computerized-provider-order-entry-implementation-no-association-increased-mortality-rates
November 16, 2022 - Study
Computerized provider order entry implementation: no association with increased mortality rates in an intensive care unit.
Citation Text:
Del Beccaro MA, Jeffries HE, Eisenberg MA, et al. Computerized provider order entry implementation: no association with increased mortality ra…
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psnet.ahrq.gov/issue/assessing-stops-framework-coping-intraoperative-errors-evidence-efficacy-hints-hubris-and
June 14, 2023 - Study
Assessing the STOPS framework for coping with intraoperative errors: evidence of efficacy, hints of hubris, and a bridge to abridging burnout.
Citation Text:
D'Angelo JD, Rivera M, Rasmussen TE, et al. Assessing the stops framework for coping with intraoperative errors: evidence of…
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psnet.ahrq.gov/issue/temporal-trends-patient-safety-netherlands-reductions-preventable-adverse-events-or-end
June 30, 2021 - Commentary
Temporal trends in patient safety in the Netherlands: reductions in preventable adverse events or the end of adverse events as a useful metric?
Citation Text:
Shojania KG, van de Mheen PJM-. Temporal trends in patient safety in the Netherlands: reductions in preventable advers…
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psnet.ahrq.gov/issue/emergency-department-contribution-prescription-opioid-epidemic
June 21, 2016 - Study
Classic
Emergency department contribution to the prescription opioid epidemic.
Citation Text:
Axeen S, Seabury SA, Menchine M. Emergency Department Contribution to the Prescription Opioid Epidemic. Ann Emerg Med. 2018;71(6):659-667.e3. doi:10.1016/j.anneme…
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psnet.ahrq.gov/issue/safety-culture-and-complications-after-bariatric-surgery
August 02, 2015 - Study
Safety culture and complications after bariatric surgery.
Citation Text:
Birkmeyer NJO, Finks JF, Greenberg CK, et al. Safety culture and complications after bariatric surgery. Ann Surg. 2013;257(2):260-5. doi:10.1097/SLA.0b013e31826c0085.
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DOI …
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psnet.ahrq.gov/issue/adverse-events-experienced-while-transferring-critically-ill-patient-emergency-department
November 13, 2024 - Study
Adverse events experienced while transferring the critically ill patient from the emergency department to the intensive care unit.
Citation Text:
Gillman L, Leslie G, Williams T, et al. Adverse events experienced while transferring the critically ill patient from the emergency de…
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digital.ahrq.gov/sites/default/files/docs/publication/AppendixA_Comm_Tech_For_AA_Women.pdf
February 01, 2010 - Nearly every
day 3
5
In the last month
, how often
have you felt that you were
unable … Never 0
For 5-8, a score
of 8 or more
would lead to the
stress script
5 In the last month … Sometimes 2
5 In the last month
, how often have you felt that you were unable to control … Almost never 3
6 In the last month
, how often have you felt confident about your ability … Never 4
7 In the last month
, how often have you felt that things were going your way?
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psnet.ahrq.gov/node/35602/psn-pdf
September 27, 2017 - review-medication-administration-errors-reported-large-psychiatric-hospital-
united-kingdom
The investigators analyzed incident reports from a 42-month
-
psnet.ahrq.gov/node/35271/psn-pdf
June 29, 2009 - The authors report a
70% decline in adverse drug events in the course of the 18-month study period.
-
psnet.ahrq.gov/node/45215/psn-pdf
April 08, 2018 - survey of outpatient general
pediatricians, about one-third reported making a diagnostic error every month
-
psnet.ahrq.gov/node/41102/psn-pdf
February 01, 2012 - medication-administration-errors-older-people-long-term-residential-care
Data from a barcode medication administration (BCMA) system revealed that over a 3-month
-
effectivehealthcare.ahrq.gov/sites/default/files/01_arthritis_potential_high_impact_2012-12-10.pdf
January 01, 2012 - The wholesale cost was reported as $2,055 per month for 30 tablets, or
about $25,000 annually, a cost … (n=12) and 12-month (n=10) followup. … at baseline (p<0.0005).
25
By
24-month followup, all evaluated outcomes were significantly lower … than those observed at
12-month followup. … group than placebo group; at month 6,
higher percentages of patients given active treatment had a
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digital.ahrq.gov/sites/default/files/docs/publication/uc1hs015350-horn-final-report-2008.pdf
January 01, 2008 - Starting 6 months after implementation, and each 6-month period
thereafter, we re-measured areas assessed … The goal was to reduce time spent on monthly change-over
(redoing the MAR every month) and time spent … The 18-month feedback did not reflect improvement compared to
baseline.
• Q#2. … Post-Implementation
12-month Post-Implementation 18-month Post-Implementation
CNA feedback is … Post-Implementation
12-month Post-Implementation 18-month Post-Implementation
21
Figure 3.
-
digital.ahrq.gov/sites/default/files/docs/citation/r21hs022336-farris-final-report-2017.pdf
January 01, 2017 - We will compare the population’s empirical
probability distribution across message types during month … in
adherence attributable to the novelty of the intervention) with the probability distribution in month … By month 3, that number rose to 65% and
by month 6, it was approximately 80%. … We have requested the claims for the 6 month period following the study
and they will be received by … The PDCs from the 6 month prior to the intervention were compared to the period 6 months
during the
-
digital.ahrq.gov/sites/default/files/docs/publication/r21hs019726-kahn-final-report-2014.pdf
January 01, 2014 - That is, over half of the prescriptions did not have a corresponding
fill event in the 6-month time … Over a 3-month
pilot implementation period, the clinicians noted that the decision support alert is … If there is an GPI8 Rx
between E6 months and
E1 month(Visit 1)….
2. … Look for closest
matching GPI8 Rx
(Visit 1) between H6
months and H1
month
1. … Find the first GPI 8 Fill in
6 month 3me window
0.
-
digital.ahrq.gov/sites/default/files/docs/citation/r21hs024540-ferucci-final-report-2019.pdf
January 01, 2019 - The RAPID3 was
repeated at the 6- and 12-month telephone follow-up, and the telemedicine perception … for quality measures in all participants, but there was some loss to
follow-up for the 6- and 12-month … Of those, 89 (73%) completed the 6
month follow-up RAPID3 and 74 (61%) completed the 12 month follow-up … All participants had the baseline and 12 month medical record
abstractions completed. … activity or quality of care
compared to in-person only visits for the measures in this study over a 12-month
-
digital.ahrq.gov/sites/default/files/docs/publication/r01hs015413-samore-final-report-2008.pdf
January 01, 2008 - The other 14 clinics averaged at least 300 electronic
prescriptions per month (range: 310 – 2,762). … B; average X-ray
orders per provider per month were 5 (1 - 32) for group A and 7.8 (1-27) for group … Ten
providers in group A and 4 providers in group B averaged more than 5 laboratory orders per
month … The fraction of algorithms completed was 40% during the first month of
implementation and declined to … 2% by the last month.