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  1. www.ahrq.gov/hai/tools/perinatal-care/modules/teamwork/understand-sci-fac-guide.html
    May 01, 2017 - increase their ability to learn from mistakes and implement procedures to help prevent serious errors from occurring
  2. www.ahrq.gov/sites/default/files/wysiwyg/research/findings/final-reports/17358-Strom-draft-1.pdf
    June 30, 2010 - We excluded outcomes occurring on the first day of statin exposure because of pharmacological data … The baseline sCr measurement was the lowest sCr value occurring within 365 days before the elevated … Outcomes occurring during follow-up time were attributed to the current exposure category. … Outcomes occurring within 30 days after the included follow-up time were attributed to the prior exposure … Outcomes occurring more than 30 days after included follow-up time were not included in the analysis
  3. www.ahrq.gov/news/newsletters/e-newsletter/901.html
    February 01, 2024 - Why simulation matters: a systematic review on medical errors occurring during simulated health care.
  4. Four Moments Poster (pdf file)

    www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/four-moments/poster-one-option.pdf
    November 01, 2019 - Four Moments Poster AHRQ Pub. No. 17(20)-0028-EF November 2019 Moment 1 occurs at the time initiation of antibiotic therapy is considered: Ask, “Does my patient have an infection that requires antibiotics?” occurs when the dec…
  5. www.ahrq.gov/patient-safety/capacity/candor/demo-program/plan-grants/findings.html
    May 01, 2016 - determined to involve a potential transition of care event, defined by a multidisciplinary team as occurring … collected and reviewed the hospital’s clinical and administrative documents to identify potential failures occurring
  6. www.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/officebasedcare/handouts/readiness.pdf
    August 01, 2005 - Identify the changes that are occurring or will occur during the timeframe within which TeamSTEPPS implementation … Identify any current safety and quality initiatives (e.g., Lean Six Sigma) that may already be occurring
  7. www.ahrq.gov/patient-safety/resources/liability/neumiller.html
    August 01, 2017 - several studies have highlighted the significant liability claim costs associated with preventable ADEs occurring … claims analyzed, 73 percent of them were deemed preventable and were nearly evenly divided between ADEs occurring … This project highlights the need to proactively implement strategies to minimize potential ADEs occurring
  8. www.ahrq.gov/patient-safety/reports/liability/neumiller.html
    August 01, 2017 - several studies have highlighted the significant liability claim costs associated with preventable ADEs occurring … claims analyzed, 73 percent of them were deemed preventable and were nearly evenly divided between ADEs occurring … This project highlights the need to proactively implement strategies to minimize potential ADEs occurring
  9. www.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/teamwork/learn-from-defects-fac-guide.html
    July 01, 2023 - CUSP and Sensemaking tools help teams identify defects and identify ways to prevent them from occurring
  10. www.ahrq.gov/cahps/surveys-guidance/item-sets/hp/suppl-policyholder-hp-adult.html
    December 01, 2018 - Supplemental Items for the CAHPS Health Plan Adult Survey 5.0: Relation to Policyholder Population version: Adult Download these items: English (Word, 24 KB) Users of the CAHPS ® Health Plan Survey are free to incorporate supplemental items in order to meet the needs of their organizations, local marke…
  11. www.ahrq.gov/news/newsletters/e-newsletter/820.html
    June 01, 2022 - Pharmacotherapy interventions for adolescent co-occurring substance use and mental health disorders:
  12. www.ahrq.gov/news/newsletters/e-newsletter/845.html
    January 01, 2023 - Emergency Department Visits Despite no significant change in mental health emergency department visits occurring
  13. www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/data-change-slides.pptx
    April 01, 2022 - from it Assessment of current status Determination if progress is being made or not If progress is occurring
  14. www.ahrq.gov/cahps/surveys-guidance/item-sets/cg/suppl-providertype-cg30-adult.html
    December 01, 2018 - Supplemental Items for the CAHPS Clinician & Group Adult Survey 3.0: Provider Type Population Version: Adult Download these items: English (Word, 25 KB) Users of the CAHPS Clinician & Group Survey are free to incorporate supplemental items in order to meet the needs of their organizations, local markets…
  15. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/candor/module4/module4-event-reporting-investigation-analysis.pptx
    September 10, 2015 - best practice of creating a hotline for staff to call when they feel a CANDOR event has occurred or is occurring
  16. www.ahrq.gov/sites/default/files/2024-12/dalton-report.pdf
    January 01, 2024 - Traditionally, management of pregnancy loss has been dilation and curettage (D&C), most often occurring … Traditional management has been dilatation and curettage (D&C), most often occurring in an operating … surgical center, and the place of service was not an office, the procedure was also classified as occurring … hospitals, and there were no inpatient procedure or revenue codes, the procedure was classified as occurring … we were unable to assess whether early adoption of misoprostol and/or office uterine evacuations is occurring
  17. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol1/Grayson.pdf
    January 01, 2003 - and reported increased distractions and feelings of fatigue during the 30 minutes prior to the error occurring
  18. www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/nicu_toolkit/nicupacket-apb-pda.pdf
    December 13, 2013 - NICU Family Information Packet, Appendix B, Patent Ductus Arteriosus Patent Ductus Arteriosus Characteristics ■ A persistent open connection beyond 3 months of age between the pulmonary artery and the aorta with blood flow from the aorta to the pulmonary artery. ■ An open ductus may lead to: – Congestive heart…
  19. www.ahrq.gov/cahps/surveys-guidance/item-sets/hp/suppl-utilization-hp-adult.html
    December 01, 2018 - Supplemental Items for the CAHPS Health Plan Adult Survey 5.0: Utilization Population version: Adult Download these items: English (Word, 24 KB) Users of the CAHPS ® Health Plan Survey are free to incorporate supplemental items in order to meet the needs of their organizations, local markets, and/or au…
  20. www.ahrq.gov/cahps/surveys-guidance/item-sets/hp/suppl-utilization-hp-child.html
    December 01, 2018 - Supplemental Items for the CAHPS Health Plan Child Survey 5.0: Utilization Population version: Child Download these items: English (Word, 28 KB) Users of the CAHPS ® Health Plan Survey are free to incorporate supplemental items in order to meet the needs of their organizations, local markets, and/or au…

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