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www.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/situ/sim-tool-guidance.html
July 01, 2023 - The most powerful learning occurs during debriefing, when participants have a chance to review their
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/lab-testiing/lab-testing-casereport.pdf
September 05, 2017 - What happens if a problem occurs?
o Where does the process typically occur? … • o How much, if any, down time occurs? … What happens if a problem occurs?
o Where does the process typically occur? … • o How much, if any, down time occurs?
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www.ahrq.gov/diagnostic-safety/resources/issue-briefs/distributed-cognition-er-nurses4.html
August 01, 2022 - While overlap in patient interactions still occurs, the physician and nurse make a deliberate effort
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa-2/130-ss-swiss-cheese-fg.docx
April 01, 2025 - AHRQ Safety Program for MRSA Prevention: Targeting SSI
Learning From Defects: Applying the “Swiss cheese model” of System Failure
Surgical Services
For: Cardiac, Hip and Knee Joint Replacement, and Spinal Fusion Surgeries
Slide Title and Commentary
Slide Number and Slide
Learning From Defects: Applying the “Swiss C…
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www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/CHIPRA202-Materials_IIIA.pdf
January 01, 2014 - Measure
Developer Measure Title Measure Description
Type of
Measure/Level of
Measurement Data Source Claims Information Additional Information
NCQA/CAHMI*
Rates of screening using standardized
screening tools for potential delays in
social and emotional development
[Included in Initial Core Set of Childre…
-
www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/CHIPRA204-Materials_IIIA.pdf
January 01, 2014 - Measure
Developer Measure Title Measure Description
Type of
Measure/Level of
Measurement Data Source Claims Information Additional Information
NCQA/CAHMI*
Rates of screening using standardized
screening tools for potential delays in
social and emotional development
[Included in Initial Core Set of Childre…
-
www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/CHIPRA205-Materials_IIIA.pdf
January 01, 2014 - Measure
Developer Measure Title Measure Description
Type of
Measure/Level of
Measurement Data Source Claims Information Additional Information
NCQA/CAHMI*
Rates of screening using standardized
screening tools for potential delays in
social and emotional development
[Included in Initial Core Set of Childre…
-
www.ahrq.gov/patient-safety/reports/liability/corbett.html
August 01, 2017 - Full disclosure when harm occurs from a medication error is a best practice. … management, rather than the underlying disease, within 3 weeks of discharge. 15 Poor care coordination that occurs
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa-2/003-ss-antimicrobial-prophylaxis-part-2-fg.docx
April 01, 2025 - AHRQ Safety Program for MRSA
Prevention: Targeting SSI
Antimicrobial Prophylaxis: Part 2 Beyond the Basics
Surgical Services
For: Cardiac, Hip and Knee Joint Replacement, and Spinal Fusion Surgeries
Slide Title and Commentary
Slide Number and Slide
Antimicrobial Prophylaxis: Part 2, Beyond the Basics
SAY:
This pr…
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/long-term-care/resources/ontime/fallsprev/ontimefallpxreports-ig.pdf
June 02, 2025 - AHRQ's Safety Program for Nursing Homes: On-Time Falls Prevention Training
AHRQ’s Safety Program for Nursing Homes: On-Time Falls Prevention Training 1
On-Time Falls
Prevention:
Reports
AHRQ’s Safety Program for Nursing
Homes: On-Time Falls Prevention
Training
Slide 1: Introduction to Falls Pr…
-
www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/long-term-modules/module4/mod4-slides.html
March 01, 2017 - When an adverse event occurs, it can be difficult for a care provider to take ownership and communicate
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www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/0082textdesc.pdf
January 01, 2012 - )
Definition: The group of
patients in the
denominator for whom
a process or outcome of
care occurs
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/pdi/d4d_pdi05-nqi01-pneumothorax-bestpractices.pdf
May 16, 2016 - • Iatrogenic pneumothorax in children occurs at rates that are at least comparable to those in
adults
-
www.ahrq.gov/patient-safety/settings/long-term-care/resource/injuries/fallspx/manapb5txt.html
December 01, 2017 - Record the date of any fall that occurs after entry.
-
www.ahrq.gov/hai/cauti-tools/archived-webinars/assess-adapt-slides.html
July 01, 2018 - Are staff empowered to stop the procedure if violation occurs?
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4c_combo_psi06-pneumothorax-bestpractices.pdf
May 20, 2016 - Iatrogenic pneumothorax (IP) is a life-threatening complication seen in 3% of ICU patients.1
• IP occurs
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4r_combo_pdi05-nqi01-pneumothorax-bestpractices.pdf
May 16, 2016 - • Iatrogenic pneumothorax in children occurs at rates that are at least comparable to those in
adults
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/pdi/b1_pdi_applyingpdis.pdf
March 01, 2016 - Applying the AHRQ Pediatric Quality Indicators to Hospital Data
Pediatric Toolkit for Using the AHRQ Quality Indicators
How To Improve Hospital Quality and Safety
i Tool B.1
Applying the AHRQ Pediatric Quality Indicators to Hospital Data
What is the purpose of this tool? This tool provides guidance on how to c…
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/b1_combo_applyingqis.pdf
March 01, 2016 - Applying the AHRQ Quality Indicators to Hospital Data
Toolkit for Using the AHRQ Quality Indicators
How To Improve Hospital Quality and Safety
i Tool B.1
Applying the AHRQ Quality Indicators to Hospital Data
What is the purpose of this tool? This tool provides guidance on how to calculate your
hospital’s rat…
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www.ahrq.gov/priority-populations/observances/hispanic-heritage/index.html
October 01, 2021 - Grantees Focusing on Hispanic and Latino Populations
Peter Yellowlees, M.D.
“I have found it fascinating to see the way that almost all patients speak differently, using simpler phrases and less words, when using an interpreter. Their descriptions of clinical symptoms and histories is much ric…