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digital.ahrq.gov/sites/default/files/docs/citation/r03hs027006-sun-final-report-2023.pdf
January 01, 2023 - Institute of Medicine (US) Committee on the Work Environment for Nurses and Patient
Safety. … Guide to Patient and Family Engagement in Hospital Quality and
Safety, https://www.ahrq.gov/patient-safety … Joint Commission journal on
quality and patient safety / Joint Commission Resources 2012; 38: 560-565 … The National Database of Nursing Quality Indicators. … https://www.ahrq.gov/patient-safety/patients-families/engagingfamilies/index.html
https://www.jointcommission.org
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digital.ahrq.gov/sites/default/files/docs/citation/r21hs025238-xie-final-report-2020.pdf
January 01, 2020 - matching the situation to the patterns they have learned
(e.g., obtaining blood cultures in febrile patients … change of clinical • Focusing only on current status • Providing information on
indicators (analytical … ) • Different patients having different current status and trend
• Matching patient conditions signs … building a
with clinical patterns learned
from past experience
(intuitive)
• Focusing only on clinical indicators … Work system design for patient safety: the
SEIPS model.
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digital.ahrq.gov/research-method/time-series
January 01, 2023 - Samantha
Project Name
Understanding CancelRX: Impact on Clinical Workflows, Medication Safety … Risks, and Patient Outcomes
Preventing Wrong-Drug and Wrong-Patient Errors With … CPOE Systems
Understanding CancelRX: Impact on Clinical Workflows, Medication Safety … Understanding CancelRX: Impact on Clinical Workflows, Medication Safety Risks, and Patient Outcomes - … Samantha
Project Name
Understanding CancelRX: Impact on Clinical Workflows, Medication Safety
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digital.ahrq.gov/location/usa-il-evanston
January 01, 2023 - USA, IL, Evanston
Preventing Wrong-Drug and Wrong-Patient Errors With … significant increase in problem placement rates, a modest increase in order abandonment (when a wrong patient … Principal Investigator(s)
Rao, Goutham
Tools for Optimizing Medication Safety … Centers for Education and Research on Therapeutics-funded project was focused on the improvement of patient … safety through the development and refinement of tools for safer medication use.
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digital.ahrq.gov/ahrq-funded-projects/e-prescribing-impact-patient-safety-use-and-cost
January 01, 2023 - E-Prescribing Impact on Patient Safety, Use, and Cost
Project Final Report ( PDF … Of these 1,198 clinicians wrote one or more e-prescription that was filled by 64,749 patients. … E-Prescribing Impact on Patient Safety, Use, and Cost - 2009
×
Disclaimer
Disclaimer … E-Prescribing Impact on Patient Safety, Use, and Cost - Final Report. … Principal Investigator: Weissman, Joel Project Name: E-Prescribing Impact on Patient Safety, Use, and
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digital.ahrq.gov/sites/default/files/docs/publication/r01hs016759-ralston-final-report-2012_0.pdf
January 01, 2012 - Further understand the potential benefits and the safety of the shared record among
patient with diabetes … These studies suggest that SMRs may have some unanticipated negative impacts on the quality,
safety … accrued into the Group Health diabetes registry
and to be able to assess clinical quality of care indicators … with certain patient
and provider characteristics and indicators of better clinical quality of care … Poisson regression models within a GEE
framework to estimate the adjusted rate ratio of meeting three indicators
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digital.ahrq.gov/sites/default/files/docs/citation/r21hs025005-snyder-final-report-2019.pdf
January 01, 2019 - 6 Unsafe drug (anti-hypertensives; benzodiazepine; hypnotic;
antidepressant) for patient due to patient … Pharmacists indicated that
most (89.3%) patients were receiving their first CMR. … Most (58.6%) of these MTPs related to a
need for patient immunizations or problems with patients’ medication … Alerts are perceived as more highly
influenced by payer goals, rather than
patients’ clinical and safety … MTM alerts contain too little patient-specific
information, positioning pharmacists to rely
on patients
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digital.ahrq.gov/sites/default/files/docs/citation/r01hs024945-lambert-final-report-2022.pdf
January 01, 2022 - Key Words: medication safety, wrong-drug, wrong-patient, indication, clinical decision support, retract-and … Thus 0.1% of inpatient doses resulted patients getting
the wrong-drug (25%*0.39%). … We interpret this as evidence of
patient safety improvement because each abandonment is a self-intercepted … Joint Commission Journal on Quality and Patient Safety. 2006;32(2):73-80.
4. … Patient Safety 2015, draft report for comment.
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digital.ahrq.gov/key-topics/computerized-disease-registries
January 01, 2010 - , can be routinely tested and monitored, even if the patient has not been seen by their primary provider … It also tracks the diabetes population to identify trends in key indicators of care. … Registries for Evaluating Patient Outcomes: A User's Guide Source : Gliklich RE, Dreyer NA, eds. … clinical effectiveness or cost effectiveness of health care products and services, to measure or monitor safety … Produce population reports to monitor and stratify patients.
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digital.ahrq.gov/sites/default/files/docs/SFQD_Slides%20(2).pdf
January 01, 1993 - Enhancing patient safety by reducing medication errors
system-wide
3. … safety by reducing medication errors
— Enhancing uniform high quality by measuring performance
— Expanding … • Physician feedback system
• Clinician-level view of performance on
problem-oriented quality indicators … : “drill down” to Smart — Individual patient: “drill down” to Smart
Form
— Lists of patients: link … show adherence with targets
Red, yellow, and green indicators
show adherence with targets
Zero defect
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digital.ahrq.gov/ahrq-funded-projects/improving-otitis-media-care-electronic-health-record-ehr-based-clinical/annual-summary/2010
January 01, 2010 - The Children's Hospital of Philadelphia
Funding Mechanism
RFA: HS07-006: Ambulatory and Safety … The full intervention consists of: 1) a method for linking all services a patient receives from any physician … The project team provided six rounds of feedback reports on four OM quality indicators directly to physicians … The feedback report includes quality adherence information such as the proportion of patients with acute … physician use of the EHR during pediatric clinical encounters and the physician interactions with the patient
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digital.ahrq.gov/sites/default/files/docs/publication/r01hs015175-weissman-final-report-2007.pdf
January 01, 2007 - E-prescribing Impact on Patient Safety, Use and Cost
Grant Final Report
Grant ID: 5 R01 HS015175-02 … E-prescribing Impact on Patient Safety, Use and Cost
Inclusive dates: 09/03/04 - … make important contributions to patient safety. … “Emerging Research on Patient Safety:
Issues of Measurement, Causes, and Evaluation”. … “Research on Patient Safety at the Other
IHP: Measurement, Causes, and Evaluation”.
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digital.ahrq.gov/key-topics/clinical-decision-support
November 04, 2009 - Investigator: Henry Chueh State: MA
Title: A Systems Engineering Approach: Improving Medication Safety … Summary: Clinical decision support (CDS) provides clinicians, staff, patients, or other individuals … For example, a study by van der Sijs et al . found that safety alerts were overridden by clinicians … care and patient safety. … They typically provide a summary of the user's performance for key indicators or metrics and comparison
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digital.ahrq.gov/ahrq-funded-projects/e-prescribing-impact-patient-safety-use-and-cost/annual-summary/2009
January 01, 2009 - E-Prescribing Impact on Patient Safety, Use, and Cost - 2009
Project Name
E-Prescribing … Impact on Patient Safety, Use, and Cost
Principal Investigator
Weissman, Joel
Organization … safety by providing real-time drug information to the prescriber. … safety, use, and cost of prescription medications. … The study used or modified current measures of poor prescribing habits, utilization, and selected patient
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digital.ahrq.gov/sites/default/files/docs/citation/workflowredesignrfi.pdf
July 01, 2010 - *As a way to track changes in patient safety culture over time. … safety and quality issues among
providers and staff.The Medical Office Survey on Patient
Safety Culture … SOPS=Survey on Patient
Safety Culture. SOW=statement of work. … All of this promotes quality
care and patient safety. … safety Culture (SOPS)
*A tool that medical offices can use to assess patient safety culture and quality
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digital.ahrq.gov/2018-year-review/executive-summary
January 01, 2018 - Rudin
A simple app, designed with input from patients, resulted in 92 percent of patients continuing … Project
Research investment: $1.5M
AHRQ health IT safety research was prominently featured … Stories about these pioneering health IT safety research projects are captured in the section of this … Table 3: Health IT Safety Research Spotlights. … Enhancing Medication CPOE Safety and Quality by Indications-Based Prescribing
Research investment:
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digital.ahrq.gov/ahrq-funded-projects/medication-monitoring-vulnerable-populations-information-technology-mmiti/annual-summary/2010
January 01, 2010 - Available data highlights significant potential for patient safety improvement by increasing rates of … , if providers fully understand how to link the process of therapeutic monitoring to differences in patient … Data to fulfill the measures were collected by a newly-developed, bidirectional interface and patient … measures of medication monitoring for vulnerable BMS CHC populations that impact patient outcomes. ( … Patient-related factors may include aversion to needle sticks, cost, or logistical barriers.
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digital.ahrq.gov/health-it-tools-and-resources/health-it-bibliography/return-investment/reviewing-benefits-and-costs
Reviewing the Benefits and Costs of Electronic Health Records and Associated Patient Safety Technologies … Number: 159-168 Link: Reviewing the Benefits and Costs of Electronic Health Records and Associated Patient … Safety Technologies Category: Return on Investment
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digital.ahrq.gov/sites/default/files/docs/page/acts-meeting-with-notes-01302019.pdf
January 30, 2019 - Description of Improved Care Process(es)
AHRQ Patient Safety Network/Patient Safety Primers
Practice-Based … Safety Culture
► Hospital and Health System Resources
► Long Term Care Resources
► Nursing Home Safety … Resources
► [Behavioral Health] Integration Academy
► Patient Safety Organization Program
► [CV Health … Outcomes
► AHRQ Quality Indicators
► Pain Items in CAHPS
Not Yet Classified
► Registry of Patient … Medical Homes Resources (PCMH)
• Patient Safety Events Reports/Resources (PSnet/PSOs)
• National Healthcare
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digital.ahrq.gov/sites/default/files/docs/citation/r18hs017059-wu-final-report-2010.pdf
January 01, 2010 - Characterize provider attitudes and measure provider satisfaction with performance
indicators
4. … Patient Goal
Body Mass Index Patients 18+ BMI recorded in past 24 months
Breast Cancer
Screen … 50+ Patient received flu shot from the most recent
September 1
For each practice, 120 patients age … with their
current methods
Functionality %
Keeping medication lists 53.1%
Monitoring medication safety … Easier
% of
Respondents:
No Change
% of
Respondents:
More Difficult
Monitoring medication safety