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www.ahrq.gov/research/findings/final-reports/ptfamilyscan/ptfamily5.html
July 01, 2018 - Take medication safety as an example. … and families to engage in issues related to safety and quality. … and family engagement in safety and quality issues. … For instance, with Patient and Family Advisory Councils, patients and family members can participate … and family engagement in hospital quality and safety is in a nascent stage of development.
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digital.ahrq.gov/sites/default/files/docs/care-transitions-slides-092619.pdf
September 26, 2019 - Notify
Update
Patient Safety Dashboard
Bedside Display
PDTK: Checklist & Video
PDTK … Summarized checklist responses displayed in safety dashboard were
too broad and non-specific. … –a
clinician
“I would look at [the safety dashboard] sometimes and wonder
what [the patient … "Patient race/ethnicity and shared medical record use among diabetes patients." … Finding out that a patient, who was on the
primary care’s roster of patients, was
discharged from the
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digital.ahrq.gov/sites/default/files/docs/publication/uc1hs015437-waters-final-report-2008.pdf
January 01, 2008 - safety, cost, access to care and overall patient outcomes. … Patient
Travel distance- Patient Study survey question, miles Patient
Travel distance- Physician … Patient satisfaction has been high - 95 % of patients
indicated their telemedicine visit was as good … Safety Conference,
Rockville, Maryland, June 2006. … Annual Health Information
Technology and Patient Safety Conference, Bethesda,
Maryland, September 2007
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psnet.ahrq.gov/issue/characteristics-initial-prescription-episodes-and-likelihood-long-term-opioid-use-united
April 24, 2018 - Opioid use has become a growing patient safety concern. … with younger, male, and privately insured patients. … March 14, 2018
Patient safety after implementation of a coproduced family centered communication … November 12, 2014
Patient safety climate in 92 US hospitals: differences by work area … February 4, 2009
A case for safety leadership team training of hospital managers.
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digital.ahrq.gov/sites/default/files/docs/page/sustainability-partnerships-and-teamwork-in-health-it-implementation.pdf
December 01, 2012 - One value
grantee indicated that patient care delivery organizations that compete for the same patients … Comprehensive Information Technology (IT) Solution for Quality and Patient Safety:
Final Report (Prepared … Bar Coding for Patient Safety in Northern Michigan (Prepared by Munson Medical Center under
Grant No … http://healthit.ahrq.gov/
OehlersUC1HS14878
Enhancing Patient
Safety through a
Universal EMR System … During the year, data on those quality indicators
are presented at the provider level,
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psnet.ahrq.gov/web-mm/electronic-err
April 01, 2014 - practices used in the past, but rather to use the richer set of patient safety tools provided by the … The safety practices described in this case study (eg, informing the patient of the error, assessing … Continue to use best practice safety techniques (eg, verifying critical patient information) when making … Patient safety: achieving a new standard for care. … Committee on Data Standards for Patient Safety.
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psnet.ahrq.gov/perspective/patient-safety-and-opioid-medications
January 01, 2015 - Patient Safety and Opioid Medications. PSNet [internet]. … Patient Safety and Opioid Medications. PSNet [internet]. … How Is This a Patient Safety Issue? … a minimum, to better educate and monitor patients on opioids as part of a broad safety strategy. … Patient Safety and Opioid Medications. PSNet [internet].
-
psnet.ahrq.gov/innovation/michigan-hospital-medicine-safety-consortium-hms-finds-infectious-diseases-id-physician
July 23, 2024 - Innovation Patient Safety Focus
The initiative addresses the inappropriate use of, and complications … Patient Safety Network. December 1, 2012. Accessed November 17, 2021. … Patient Safety Innovations
Patient and Family Centered … Management of Sepsis
May 31, 2023
Patient Safety Innovations … Plans
May 31, 2023
Patient Safety Innovations
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digital.ahrq.gov/sites/default/files/docs/page/08-0085_bcma.pdf
August 01, 2008 - Patient safety is a top priority for AHRQ, and Bar-coded medication administration
(BCMA) holds promise … Medication errors pose a serious threat to patient safety. … BCMA can improve patient safety. … Trends among AHRQ-funded BCMA projects suggest that
patients whose providers use BCMA technology may … safety.
-
psnet.ahrq.gov/node/73901/psn-pdf
September 29, 2021 - and pharmacists reviewing
relevant clinical electronic health record (EHR) data for all hospitalized patients … Using the Safer Dx instrument, the research team retrospectively reviewed patient electronic health record … antimicrobial-stewardship
https://psnet.ahrq.gov/issue/using-good-catches-promote-just-culture-and-perioperative-patient-safety
-
effectivehealthcare.ahrq.gov/sites/default/files/related_files/osteoarthritis-pain_executive.pdf
October 01, 2011 - We
also included studies that report safety in patients with
rheumatoid arthritis or who were taking … ), diclofenac (10/100
patient-years), and ibuprofen (11/100 patient-years). … disease
prevention, usually at lower
prophylactic doses
GI harms: A systematic review of individual patient … though diclofenac was associated with the highest rate
of hepatic laboratory abnormalities (78/1000 patient … -
years, vs. 16 to 28/1000 patient-years for the other
NSAIDs).
-
digital.ahrq.gov/sites/default/files/docs/page/reduction-in-hospital-acquired-complications-and-infections-quick-reference-guide.pdf
January 01, 2010 - Measure Category: Clinical Outcomes
Quality Domain: Patient Safety
Current Findings in the Literature … safety initiatives. … While they fall into a variety of categories, they all
significantly impact patient safety, causing morbidity … Infection control: a problem for patient
safety. N Engl J Med 2003;348(7):651-6.
2. … Making health care safer: a critical
analysis of patient safety practices.
-
psnet.ahrq.gov/issue/association-between-opioid-tapering-and-subsequent-health-care-use-medication-adherence-and
August 25, 2021 - Rates of prescription opioid misuse and abuse led to recommendations for dose tapering for patients … changes in visits and antibiotic prescribing during the Agency for Healthcare Research and Quality Safety … July 13, 2022
The abrupt expansion of ambulatory telemedicine: implications for patient … safety. … October 21, 2020
Telediagnosis for Acute Care: Implications for the Quality and Safety
-
psnet.ahrq.gov/perspective/conversation-heidi-wald-md
November 26, 2019 - We spoke with her about patient safety concerns when caring for frail older patients.
Dr. … KH: Besides medications, are there other patient safety topics related to frail older patients that … Patient Safety in Frail Older Patients
November 26, 2019
sup {font-size: 0.8em; … Patient Safety Considerations in Frail Older Patients The hazards of hospitalization and overtreatment … Given the magnified patient safety risk frail older patients experience, clinicians and other providers
-
psnet.ahrq.gov/issue/what-about-doctors-impact-medical-errors
January 14, 2015 - Patients are the first victims when medical mistakes occur, and studies have indicated that these incidents … Did the organization of primary care practices during the COVID-19 pandemic influence quality and safety … March 27, 2024
Missed nursing care in surgical care- a hazard to patient safety: a quantitative … Critical incident stress management (CISM) in complex systems: cultural adaptation and safety
-
digital.ahrq.gov/sites/default/files/docs/citation/r01hs022087-singh-final-report-2018.pdf
January 01, 2018 - Several
patient-related factors were found, such as language barriers, patients not using the patient … Improving Ambulatory Patient Safety. … Journal of Patient Safety. 2008;4(4).
24. … The role of electronic health records in patient safety events. … Pennsylvania Patient Safety Authority. 2012;9(4):113-21.
46.
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effectivehealthcare.ahrq.gov/sites/default/files/pdf/weight-loss-surgery_research-protocol.pdf
December 14, 2010 - The benefits/risks ratio in the long term is also a concern:
effectiveness and safety data are very … studies will be excluded: 1) studies that did not report any
outcomes of efficacy, effectiveness, or safety … Provisional analytic framework for evaluating the effectiveness and safety of
alternative approaches … to treatment of metabolic conditions in the patient population with BMI
below 35. … Provisional analytic framework for evaluating the effectiveness and safety of
alternative approaches
-
psnet.ahrq.gov/sites/default/files/2022-02/final_cme_reviewed_spotlight_loss_of_trust_and_a_missed_diagnosis_02.14.20221_-_clean_-_revised.pdf
January 01, 2022 - SAFETY:
DIAGNOSIS
21
Approach to Improving Patient Safety: Diagnosis (1)
• This case demonstrates … often did not include a physical examination.
24
Approach to Improving Patient Safety: Diagnosis … SAFETY:
MANAGEMENT
27
Approach to Improving Patient Safety: Management (1)
28
• When the patient … Approach to Improving Patient Safety: Management (4)
31
• This visit was a missed opportunity. … Approach to Improving Patient Safety: Management (5)
32
• Unfortunately, as the patient’s pain and
-
effectivehealthcare.ahrq.gov/sites/default/files/depression_hi_impact.pdf
October 01, 2014 - For example, TMS is contraindicated in patients with implanted DBS devices, and the
safety of ECT in … the stimulation parameters, and how to recognize safety concerns. … Government has approved clinical trials assessing the safety and efficacy of MDMA for
the treatment … In published results in one safety trial
investigating MDMA-assisted psychotherapy in women with PTSD … The safety and efficacy of {+/-}3,4-
methylenedioxymethamphetamine-assisted
psychotherapy in subjects
-
digital.ahrq.gov/sites/default/files/docs/publication/r18hs017157-carrow-final-report-2012.pdf
January 01, 2012 - communication, medication access and safety of patients
with chronic medical conditions. … , patient and clinician benefits, patient safety and information privacy and confidentiality
expected … Scope
Background
E-prescribing has the potential to significantly improve patient safety and clinician … effect on workflow,
patient safety, and potential barriers); and (v) perceptions regarding proposed … No providers
reported a concern with potential system breaches compromising patient safety, in spite