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361. Nurse-physician communication in the long-term care setting: perceived barriers and impact on patient safety. | PSNet
     psnet.ahrq.gov/issue/nurse-physician-communication-long-term-care-setting-perceived-barriers-and-impact-patient
     February 23, 2011 - Patient Safety February 26, 2025 National Healthcare Quality and Disparities … Reports. … AHRQ Nursing Home Survey on Patient Safety Culture: 2019 User Comparative Database Report … AHRQ Nursing Home Survey on Patient Safety Culture: 2014 User Comparative Database Report … 2011 Nursing Home Survey on Patient Safety Culture: 2011 User Comparative Database Report

362. Primary Care and Patient Safety: Opportunities at the Interface | PSNet
     psnet.ahrq.gov/perspective/primary-care-and-patient-safety-opportunities-interface
     September 28, 2022 - Primary Care, Quality of Care, and Patient Safety Primary care plays an important role in avoiding and … services, can address each of the healthcare quality aims. … of care is achieved in this context. … Agency for Healthcare Research and Quality. Six Domains of Health Care Quality. … Agency for Healthcare Research and Quality. 2019 National Healthcare Quality & Disparities Report .

363. Ending extra payment for "never events"—stronger incentives for patients' safety. | PSNet
     psnet.ahrq.gov/issue/ending-extra-payment-never-events-stronger-incentives-patients-safety
     November 13, 2024 - The National Quality Forum defined 28 never events in a 2007 consensus report that led to state mandates … for reporting and financial implications for payment of services. … motivating hospitals and clinicians to improve quality and safety. … May 13, 2021 Racial disparities in maternal mortality. … March 13, 2013 Adverse Events in Hospitals: National Incidence Among Medicare Beneficiaries

364. Periodic Issue | PSNet
     psnet.ahrq.gov/periodic-issue/periodic-issue-278
     February 10, 2021 - Prior research has identified racial and ethnic disparities in United States health care and in the incidence … care disparities, including recognizing and addressing the systems failures contributing to disparities … Patient and family engagement can affect health care quality and safety.  … Book/Report Deficiencies in Inpatient Mental Health Care Coordination and Processes Prior … Report No. 20-01521-48.  

365. Economic evaluation of quality improvement interventions to prevent catheter-associated urinary tract infections in the hospital setting: a systematic review. | PSNet
     psnet.ahrq.gov/issue/economic-evaluation-quality-improvement-interventions-prevent-catheter-associated-urinary
     January 25, 2017 - July 14, 2021 Systematic review and meta-analysis of interventions for operating room … June 8, 2022 View More Related Resources National Healthcare Quality … and Disparities Reports. … December 9, 2015 Implementing a national program to reduce catheter-associated urinary … October 31, 2014 Eliminating CLABSI: A National Patient Safety Imperative.

366. Periodic Issue | PSNet
     psnet.ahrq.gov/periodic-issue/periodic-issue-449
     July 10, 2024 - Disruptive and unprofessional behavior jeopardizes patient safety and the overall quality of care. … Study Machine learning evaluation of inequities and disparities associated with … associated infections - in one hospital were analyzed to identify if disparities exist and to create … Report descriptions included all the SEIPS components and resilience capacities (e.g., preparedness, … The authors recommend a national database specific to periprocedural falls and offer suggestions on prevention

367. The University of Texas System Clinical Safety and Effectiveness Course | PSNet
     psnet.ahrq.gov/perspective/university-texas-system-clinical-safety-and-effectiveness-course
     February 01, 2011 - of care and simultaneously reduce costs. … national meetings. … Ross Professor in Humanities and TechnologyDirector, UT Houston-Memorial Hermann Center for Healthcare … Quality and Safety Professor of Medicine University of Texas Medical School at Houston Jan E. … from each other and national experts. 5.

368. Safe use of health information technology. | PSNet
     psnet.ahrq.gov/issue/safe-use-health-information-technology
     December 23, 2016 - December 23, 2016 Eliminating racial and ethnic disparities causing mortality and morbidity … August 7, 2019 Diagnostic overshadowing among groups experiencing health disparities. … June 29, 2022 Addressing health care disparities by improving quality and safety. … 2016 View More Related Resources Enhancing patient safety: a national … HIT vendors, their customers, and patients: a report of an AMIA special task force.

369. U.S. inaction lets look-alike tubes kill patients. | PSNet
     psnet.ahrq.gov/issue/us-inaction-lets-look-alike-tubes-kill-patients
     September 01, 2008 - (s) WebM&M Cases Empiric Steroids: the Good, the Bad, and … September 1, 2008 Improving patient safety with team coordination: challenges and … Investigation of urology intraoperative events leading to root cause analysis at national … June 19, 2007 View More Related Resources National Healthcare Quality … and Disparities Reports.

370. Mandatory influenza vaccination for health care workers as the new standard of care: a matter of patient safety and nonmaleficent practice. | PSNet
     psnet.ahrq.gov/issue/mandatory-influenza-vaccination-health-care-workers-new-standard-care-matter-patient-safety
     September 13, 2023 - influenza vaccination for health care workers as the new standard of care: a matter of patient safety and … September 13, 2023 Racial and ethnic differences in the experience and treatment of noncancer … 2020 View More Related Resources Patient Safety Authority Annual Reports … April 30, 2024 National Healthcare Quality and Disparities Reports. … July 30, 2014 Healthcare-associated infections: a national patient safety problem and

371. Maternal Safety | PSNet
     psnet.ahrq.gov/curated-library/maternal-safety
     January 31, 2024 - IHI Innovation Report. Laderman M, Renton M. … awareness that racial and ethnic disparities exist and that racism and bias in the hospital can lead … IHI Innovation Report. … The report outlines specific areas of concern for rural hospitals and suggests avenues for improvement … This survey of postpartum women elicited reports of adverse events, unanticipated procedures, and sense

372. Preventable mortality after common urological surgery: failing to rescue? | PSNet
     psnet.ahrq.gov/issue/preventable-mortality-after-common-urological-surgery-failing-rescue
     July 17, 2013 - This analysis of national hospital data found that while odds of overall mortality from urological surgery … This work emphasizes the need to examine disparities in patient safety outcomes. … RIS Download Citation Related Resources From the Same Author(s) National … March 5, 2025 Are physicians' perceptions of healthcare quality and practice satisfaction … : a national survey on United States operating rooms.

373. Patient safety in palliative care: a mixed-methods study of reports to a national database of serious incidents. | PSNet
     psnet.ahrq.gov/issue/patient-safety-palliative-care-mixed-methods-study-reports-national-database-serious
     May 16, 2018 - Patient safety in palliative care: A mixed-methods study of reports to a national database of serious … Patient safety in palliative care: A mixed-methods study of reports to a national database of serious … in the England and Wales National Reporting and Learning System: a mixed-methods agenda-setting study … in primary care: mixed methods analysis of national safety reports. … and racial disparities in US nursing home ratings.

374. A multidisciplinary approach to reduce central line-associated bloodstream infections. | PSNet
     psnet.ahrq.gov/issue/multidisciplinary-approach-reduce-central-line-associated-bloodstream-infections
     November 16, 2022 - Many different national initiatives aim to widely spread these evidence-based practices across medical … The authors note that changing the culture and practice of medical and nursing staff can be difficult … , taking time and perseverance. … July 19, 2023 View More Related Resources National Healthcare Quality … and Disparities Reports.

375. Injection practices among clinicians in United States health care settings. | PSNet
     psnet.ahrq.gov/issue/injection-practices-among-clinicians-united-states-health-care-settings
     January 06, 2017 - A national prospective cohort study. … August 3, 2022 National estimates of insulin-related hypoglycemia and errors leading … January 12, 2022 Preventability and causes of readmissions in a national cohort of general … Strategies to Improve Safety for People Who Use Substances October 30, 2024 National … Healthcare Quality and Disparities Reports.

376. Weekend effect on in-hospital mortality for ischemic and hemorrhagic stroke in US rural and urban hospitals. | PSNet
     psnet.ahrq.gov/issue/weekend-effect-hospital-mortality-ischemic-and-hemorrhagic-stroke-us-rural-and-urban
     January 19, 2022 - reactions using safety event reports across hospitals. … July 15, 2020 Changes in weekend and weekday care quality of emergency medical admissions … to 20 hospitals in England during implementation of the 7-day services national health policy. … April 20, 2022 Racial disparities in preventable adverse events attributed to poor care … coordination reported in a national study of older US adults.

377. Failure to Rescue | PSNet
     psnet.ahrq.gov/primer/failure-rescue
     September 15, 2024 - skill mix, and was ultimately endorsed by the National Quality Forum as a nurse-sensitive quality measure … Failure-to-rescue and disparities in emergency general surgery. … Racial and ethnic disparities in death associated with severe maternal morbidity in the United States … clinician-level quality of care. … January 26, 2022 National hospital ratings systems share few common scores and may generate

378. The incidence of adverse events in Swedish hospitals: a retrospective medical record review study. | PSNet
     psnet.ahrq.gov/issue/incidence-adverse-events-swedish-hospitals-retrospective-medical-record-review-study
     August 05, 2009 - April 30, 2024 National Healthcare Quality and Disparities Reports. … February 3, 2021 HANYS' Report on Report Cards. … November 20, 2019 The Irish National Adverse Events Study (INAES): the frequency and … of Care. … March 19, 2014 Healthcare-associated infections: a national patient safety problem and

379. Disparate perspectives: exploring healthcare professionals' misaligned mental models of older adults' transitions of care between the emergency department and skilled nursing facility. | PSNet
     psnet.ahrq.gov/issue/disparate-perspectives-exploring-healthcare-professionals-misaligned-mental-models-older
     May 11, 2022 - , and the organization. … 2021 Organizational readiness to change as a leverage point for improving safety: a national … August 7, 2019 Bedside shift report improves patient safety and nurse accountability. … View More See More About The Topic Emergency Departments Long-Term Care … Quality and Safety Professionals Emergency Medicine Geriatrics View More

380. Consumermedsafety.org | PSNet
     psnet.ahrq.gov/issue/consumermedsafetyorg
     April 12, 2019 - This redesigned Web site provides information about drug safety alerts and allows consumers to help … report and prevent medication errors. … January 26, 2023 Deep Dive: Racial and Ethnic Disparities in Health and Healthcare. … August 14, 2019 ISMP QuarterWatch Reports. … April 12, 2019 National Patient Safety Agency (NPSA).