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4341. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/33796/psn-pdf
      January 01, 2016 - There is often no agreement on whether an error occurred or not. … Hardeep Singh had a study of diagnostic errors in which 80% of the time when a diagnostic error had occurred

4342. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/852700/psn-pdf
      August 30, 2023 - After an error has occurred, we expend lots of time and resources doing event investigations to identify … However, we’re not necessarily addressing the reasons why an error has occurred, and more importantly

4343. 4. Overlap and Coordination of Federal Agency Research Portfolios in HSR and PCR | Agency for Healthcare Research and Quality
      www.ahrq.gov/healthsystemsresearch/hspc-research-study/overlap-and-coordination.html
      June 01, 2020 - interagency leveraging of overlaps described those efforts as “kind of accidental coordination” that occurred

4344. Facilitator Guide: Implementing Your SSI Prevention Bundle (doc file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/modules/implementation/imp_ssibundle_facnotes.docx
      December 01, 2017 - ASK: What occurred around the middle of the timeline?

4345. Implementing Your Surgical Site Infection Prevention Bundle: Facilitator Notes | Agency for Healthcare Research and Quality
      www.ahrq.gov/hai/tools/surgery/modules/implementation/ssi-bundle-fac-notes.html
      October 01, 2020 - Ask: What occurred around the middle of the timeline?

4346. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/836976/psn-pdf
      April 27, 2022 - In one study, local edema and infiltration occurred in 12% of patients, and complications were more

4347. IV. Evaluation Aims, Methods, and Results | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/reports/hotline/eval4.html
      May 01, 2016 - This information was collected as part of the provider supplementation process that occurred 45 days … When patients or caregivers were asked to identify where the mistake or negative effect occurred, 18 … were reported to have occurred in the hospital, seven in the emergency department, and three in a doctor

4348. Improving Patient Safety in Long-Term Care Facilities, Module 1 (pdf file)
      www.ahrq.gov/sites/default/files/publications/files/ltcmodule1.pdf
      June 01, 2012 - the blood pressure cuff and stethoscope, the pulse oximeter, and the thermometer. › See if a change occurred … shift-to-shift comparison. › Make sure the needed equipment is available. › See if a change occurred … Perhaps a small stroke occurred, or the resident has another new medical problem that is contributing

4349. Final Progress Report: EHR-Based Medication Complete Communication Strategy to Promote Safe Opioid Use (pdf file)
      www.ahrq.gov/sites/default/files/2024-01/mccarthy-report.pdf
      January 01, 2024 - Results: Demonstrated safe use occurred more often in the EMC2 group (adjusted odds ratio [aOR], 2.46 … Demonstrated safe use occurred more often in the EMC2-alone group (adjusted odds ratio [aOR], 2.46; … Implementation Analysis: The processes that occurred at the time of the ED visit had a high level of

4350. Final Progress Report: Problem Density, Workload, and Medical Error in Primary Care Practice: a WREN Study (pdf file)
      www.ahrq.gov/sites/default/files/2024-09/temte-report.pdf
      January 01, 2024 - Data collection occurred from August 2007 through March 2008. … Study visits occurred more commonly on Tuesdays (n=136) than expected and less commonly on Fridays … The high score visit occurred for a 74 year-old female continuity patient presenting with acute chest

4351. Patient Experience as a Source for Understanding the Origins, Impact, and Remediation of Diagnostic Errors, Volume 1: Why Patient Narratives Matter (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/topics/dxsafety-patient-experience-vol1.pdf
      July 01, 2023 - medical mishaps, inducing disparities in error reporting10; or ■ Might erroneously presume errors occurred … research shows that patients and families will report diagnostic experiences when asked if an “error” has occurred … patients to attribute responsibility for a problem, the less likely they are to report that the event occurred

4352. Improving Patient Safety Through Provider Communication Strategy Enhancements (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol3/Advances-Dingley_14.pdf
      February 06, 2008 - Initial pilot testing of huddles occurred within two departments: radiology and laboratory services. … They typically occurred at the beginning of the day or shift, lasted approximately 9 to 20 minutes, … timely, appropriate communication between nursing staff and providers as changes in patient conditions occurred

4353. Overview of Major Ambulatory Surgeries Performed in Hospital-Owned Facilities, 2019 (pdf file)
      hcup-us.ahrq.gov/reports/statbriefs/sb287-Ambulatory-Surgery-Overview-2019.pdf
      January 01, 2019 - Ambulatory Surgery Sample (NASS), 2019 ■ In 2019, 11.9 million encounters for major ambulatory surgeries occurred … ambulatory surgery encounters took place in facilities owned by urban hospitals, and more than 70 percent occurred … performed, including multiple surgeries within or across CCS-Services and Procedures categories that occurred

4354. Acute Renal Failure Hospitalizations, 2005-2014 #231
      hcup-us.ahrq.gov/reports/statbriefs/sb231-Acute-Renal-Failure-Hospitalizations.jsp
      November 01, 2017 - The same pattern occurred for inpatient stays with an all-listed diagnosis of acute renal failure. … Table 3 presents all-listed procedures that occurred most frequently during hospital inpatient stays … single hospitalization could contribute to more than one row in the table if more than one procedure occurred

4355. Recommendation: Latent Tuberculosis Infection in Adults: Screening | United States Preventive Services Taskforce
      www.uspreventiveservicestaskforce.org/uspstf/recommendation/latent-tuberculosis-infection-screening
      May 02, 2023 - In 2020, 71.5% of all cases of active tuberculosis in the US occurred among persons born outside the … In 2020, 4.3% of tuberculosis disease cases diagnosed in persons 15 years or older occurred in persons … experiencing homelessness and 2.6% occurred in residents of correctional facilities. 22 It is estimated

4356. S29 (pdf file)
      effectivehealthcare.ahrq.gov/sites/default/files/s29.pdf
      October 01, 2007 - patient, the equivalence of the drugs (based on current evidence), the level at which randomization occurred … (some subjects thought informed consent would be required if randomiza- tion occurred at the practice … level, but not required if randomization occurred at the plan level), the question of whether medications

4357. Overview of Hospital Stays for Children in the United States, 2012 #187
      hcup-us.ahrq.gov/reports/statbriefs/sb187-Hospital-Stays-Children-2012.jsp
      December 01, 2014 - A similar shift occurred among adults aged 18-44 years, although private insurance continued to pay for … Each of the three respiratory conditions occurred at a rate of 165 to 170 stays per 100,000 population … All other OR procedures occurred in fewer than 20,000 hospital stays and at a rate of fewer than 21 stays

4358. Improving Direct Notification of Abnormal Test Results Via Patient Portals - Final Report (pdf file)
      digital.ahrq.gov/sites/default/files/docs/citation/r21hs023602-singh-final-report-2017.pdf
      January 01, 2017 - they were incorporated into the test result process map to identify at which step each shortcoming occurred … Data Sources/Collection Aim 1 Data collection occurred between April 2015 and September 2016. … improve the usability of the test result interface.(39;40) In general, the focus group review sessions occurred

4359. Making Healthcare Safer Practices: 12. Infusion Pumps (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/research/findings/making-healthcare-safer/mhs3/infusion-pumps-1.pdf
      March 01, 2020 - reported to the FDA were related to deficiencies in device design and engineering, user errors also occurred … al., 201412 Survey investigated the extent to which standardization of infusion devices has occurred … the providers responsible for ordering, preventing the number of reorders that previously had occurred … Carayon et al., 201014 Nurses attended training sessions on smart intravenous (IV) pump use that occurred … The educational intervention occurred from January to April 2007.

4360. Screening for Colorectal Cancer: Recommendation Statement (pdf file)
      www.uspreventiveservicestaskforce.org/home/getfilebytoken/n4sdjxShTApRE6UxvyYuzG
      November 01, 2008 - Screening for Colorectal Cancer: Recommendation Statement Screening for Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement U.S. Preventive Services Task Force* Description: Update of the 2002 U.S. Preventive Services Task Force (USPSTF) recommendation statement on screening for colo- rec…