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effectivehealthcare.ahrq.gov/sites/default/files/s5.pdf
October 01, 2007 - Lohr, PhD
Background: Interest in new methods for comparative effective-
ness, drug and patient safety … Key Words: comparative effectiveness, drug safety, health care,
methods, patient safety, pharmaceuticals … For decades, researchers have used Medicaid data for
research on the initiation, continuation, and patient … Methodologic challenges to studying patient safety and
comparative effectiveness. … Developing indicators of
inpatient adverse drug events through nonlinear analysis using admin-
istrative
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www.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/teamwork/team-info-form.html
July 01, 2023 - Background Quality Improvement Team Information Form
AHRQ Safety Program for Perinatal … Role
Phone & Email Address
Labor and Delivery Medical Director
Hospital Patient … Safety Officer or Chief Quality Officer
Nurse Champion
Nurse Educator
… Support Staff (e.g., Operating Room Technicians, Ward Clerks, Nurse’s Aides)
Staff from Safety
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www.ahrq.gov/sites/default/files/publications/files/interimhacrate2014_2.pdf
November 19, 2015 - Web page for methods and data: http://www.ahrq.gov/professionals/quality-patient-
safety/pfp/index.html … /pfp/index.html
http://www.ahrq.gov/professionals/quality-patient-safety/pfp/index.html
Exhibit … Numerous other public and private initiatives to improve healthcare quality and patient safety
were … HHS and other public and private partners are
continuing to work to improve patient safety. … AHRQ’s patient safety programs continue to enable and guide improvements in health care
delivery.
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www.ahrq.gov/sites/default/files/publications2/files/interimhacrate2014_cx.pdf
November 19, 2015 - Web page for methods and data: http://www.ahrq.gov/professionals/quality-patient-
safety/pfp/index.html … /quality-patient-safety/pfp/index.html
Exhibit 1. … Numerous other public and private initiatives to improve healthcare quality and patient safety
were … HHS and other public and private partners are
continuing to work to improve patient safety. … AHRQ’s patient safety programs continue to enable and guide improvements in health care
delivery.
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digital.ahrq.gov/ahrq-funded-projects/partnership-clinician-electronic-health-record-ehr-use-and-quality-care
January 01, 2023 - barriers—including the need to redesign workflow to incorporate use of the EHR before, during, and after a patient … Medication safety after implementation of a commercial electronic health record system in five safety-net … Quantitative Technology: Electronic Health Record/Electronic Medical Record
Use of a comprehensive patient … Use of a comprehensive patient safety tool in primary care practices. … This is a protocol for data analysis which includes measures, statistical analysis and performance indicators
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www.ahrq.gov/sites/default/files/wysiwyg/research/findings/making-healthcare-safer/mhs3/patient-id-errors-1.pdf
March 01, 2020 - important National Patient Safety Goal starting in 2014 and releasing a Quick Safety issue in October … Patient identification, one component of patient safety, requires that patients, caregivers, clinicians … Effectiveness of surgical safety checklists in
improving patient safety. … Current issues in patient safety in surgery: a review. … Preoperative
room/
operating
room
Out of the 200 patients in the
study, 135 patients (68%)
were
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psnet.ahrq.gov/issue/preventing-adverse-drug-events
June 15, 2011 - August 2, 2016
Promoting Patient Safety Through Effective Health Information Technology … Reporting System for Patient Safety Events. … , and patient outcomes. … May 2, 2018
Medication governance: preventing errors and promoting patient safety. … January 27, 2016
Continuing education in patient safety: massive open online courses
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psnet.ahrq.gov/node/60858/psn-pdf
August 26, 2020 - Patient Communication Breakdowns
Patients or their caregivers sometimes receive conflicting recommendations … safety interventions designed to improve transitions of care. … Avoidable hospital readmissions | Australian Commission on Safety and Quality in Health Care. … Accessed July 3, 2020. https://www.safetyandquality.gov.au/our-work/indicators/avoidable-hospi…
2. … Medication use among inner-city patients
after hospital discharge: patient-reported barriers and solutions
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psnet.ahrq.gov/sites/default/files/2024-07/spotlight_case_mismanagement_of_acute_decompensated_heart_failure_slides_final.pptx
January 01, 2024 - outcomes in patients with non-cardiac conditions.1
11
11
Background (3)
However, the patient in … SAFETY
19
Fluid and Volume Management (1)
The patient may have benefited from immediate diuresis after … safety. … safety may not have changed the outcome for the patient in this case, but clinicians must be cautious … with end-organ injury, and emphasizing patient safety-centered disposition from the ED may help to prevent
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www.ahrq.gov/sites/default/files/2024-02/green-report.pdf
January 01, 2024 - Final Progress Report: Advancing Patient Safety Implementation through Pharmacy-Based Opioid Medication … Use Research
Title: Advancing Patient Safety Implementation through Pharmacy-Based Opioid Medication … Key Words
Opioids; medication safety; naloxone; pharmacy; syringes
Scope
Background
Use and nonmedical … safety in pharmacy and community settings. … as patient safety and workplace security.
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psnet.ahrq.gov/issue/stakeholder-challenges-purchasing-medical-devices-patient-safety
February 03, 2021 - Study
Stakeholder challenges in purchasing medical devices for patient safety. … Stakeholder challenges in purchasing medical devices for patient safety. … Stakeholder challenges in purchasing medical devices for patient safety. … December 13, 2023
Implementing and evaluating patient-focused safety technology on adult … March 13, 2024
Design for patient safety: a systems-based risk identification framework
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psnet.ahrq.gov/issue/guide-patient-and-family-engagement-hospital-quality-and-safety
December 24, 2008 - Citation Text:
Guide to Patient and Family Engagement in Hospital Quality and Safety. … This AHRQ toolkit is designed to help hospitals develop partnerships with patients around improving safety … December 18, 2008
Eliminating CAUTI: Interim Data Report: A National Patient Safety Imperative … Safety
March 27, 2024
Patient safety incidents in advance care planning for … January 8, 2018
Managing the after effects of serious patient safety incidents in the
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www.ahrq.gov/sites/default/files/wysiwyg/sops/databases/pharmacy/2015-report-part-1.pdf
January 01, 2015 - Patient Counseling (average 95 percent positive)—the extent to which patients are
encouraged to talk … Patient Counseling Patients are encouraged to talk to the pharmacist;
pharmacists spend enough time … Areas of Strength
• Patient Counseling (average 95 percent positive)—Patients are encouraged to talk … Patient Counseling: (B2) “We
encourage patients to talk to pharmacists about their medications” and … overall rating on patient safety.
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psnet.ahrq.gov/issue/supplemental-item-set-nursing-home-sops-call-pilot-participants
December 24, 2008 - The potential for workplace violence degrades patient and staff safety. … December 18, 2008
AHRQ-Funded Patient Safety Project Highlights: Improving Patient Safety … February 28, 2025
Nursing Home Survey on Patient Safety Culture. … December 20, 2023
Challenge Competition: Impact of Patient Safety Tools. … Safety by Engaging Patients and Families.
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psnet.ahrq.gov/node/843083/psn-pdf
January 25, 2023 - administrations-510k
The Food and Drug Administration (FDA) plays an important role in ensuring the safety … risk of future Class 1 FDA recall (the most
serious recall designation, indicating serious risks to patient … safety) among previously authorized devices
(predicates) with prior Class 1 recalls. … use-recalled-devices-new-device-authorizations-under-us-food-and-drug-administrations-510k
https://psnet.ahrq.gov/perspective/role-fda-ensuring-device-safety … https://psnet.ahrq.gov/perspective/safety-medical-devices
https://psnet.ahrq.gov/issue/anatomy-medical-device-recall-how-defective-products-can-slip-through-outdated-system
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/supporting/team-info-form.docx
May 01, 2017 - AHRQ Safety Program for Perinatal Care: Background Quality Improvement Team Information Form
AHRQ Safety … Name & Title
Role
Phone & Email Address
Labor and Delivery Medical Director
Hospital Patient … Safety Officer or Chief Quality Officer
Nurse Champion
Nurse Educator
Labor and Delivery … Support Staff (e.g., Operating Room Technicians, Ward Clerks, Nurse’s Aides)
Staff from Safety
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psnet.ahrq.gov/issue/wrong-patient-orders-obstetrics
September 23, 2020 - Patient misidentification errors can result in serious patient harm. … ordering errors in peripartum mother-newborn pairs: a unique patient-safety challenge in obstetrics. … September 4, 2019
Critical care clinicians' experiences of patient safety during the … March 16, 2022
Maternal and neonatal health care worker well-being and patient safety … unique patient-safety challenge in obstetrics.
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pso.ahrq.gov/sites/default/files/wysiwyg/PSO_Voluntary_Relinquishment.pdf
September 30, 2024 - Patient Safety Organization: Request For Voluntary Relinquishment … SAFETY ORGANIZATION:
REQUEST FOR VOLUNTARY RELINQUISHMENT
The Patient Safety and Quality Improvement … Act of 2005 (Patient Safety Act) authorizes the creation of Patient
Safety Organizations (PSOs). … Safety Act and Patient Safety
Rule dealing with PSO operations. … Safety Act and/or Patient Safety Rule; (b) the PSO’s
3-year listing period expires; or (c) the PSO
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/implementation-guide.pdf
April 01, 2022 - Since CLABSIs and CAUTIs will always be a potential threat to
patient care in the ICUs, this guide is … Potential
CLABSI and CAUTI infections will always be a threat to ICU patients, requiring teams to set … safety activities. … safety. … in the implementation guide, potential CLABSI and CAUTI infections will
always be a threat to ICU patients
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psnet.ahrq.gov/node/39786/psn-pdf
August 25, 2010 - trend-analysis-radiation-therapy-incidents-over-seven-years
Analysis of voluntary error reports indicated a decrease in safety … trend-analysis-radiation-therapy-incidents-over-seven-years
https://psnet.ahrq.gov/primer/reporting-patient-safety-events