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psnet.ahrq.gov/node/49661/psn-pdf
August 01, 2012 - Residual Anesthesia: Tepid Burn
August 1, 2012
Kurrek MM, Twersky RS. Residual Anesthesia: Tepid Burn. PSNet [internet]. 2012.
https://psnet.ahrq.gov/web-mm/residual-anesthesia-tepid-burn
The Case
A 42-year-old Filipino man presented to an outpatient surgery center for scheduled repair of an anal fistula.
The pat…
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psnet.ahrq.gov/node/49844/psn-pdf
October 01, 2018 - Diffusion of Responsibility Leads to Danger
October 1, 2018
Balcezak TJ, Deshpande O. Diffusion of Responsibility Leads to Danger. PSNet [internet]. 2018.
https://psnet.ahrq.gov/web-mm/diffusion-responsibility-leads-danger
The Case
A 70-year-old man was sent to the emergency department (ED) from a nursing facility…
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psnet.ahrq.gov/node/49756/psn-pdf
April 01, 2016 - Lost in Sign Out and Documentation
April 1, 2016
Detsky ME. Lost in Sign Out and Documentation. PSNet [internet]. 2016.
https://psnet.ahrq.gov/web-mm/lost-sign-out-and-documentation
The Case
A 71-year-old man presented to the emergency department with chest pain. While being evaluated by the
emergency physician, …
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psnet.ahrq.gov/node/49785/psn-pdf
February 01, 2017 - Refused Medication Error
February 1, 2017
Foley M. Refused Medication Error. PSNet [internet]. 2017.
https://psnet.ahrq.gov/web-mm/refused-medication-error
The Case
A 59-year-old man was admitted to the hospital with acute renal failure and mental status changes. He was
alert to self and place only. The patient h…
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digital.ahrq.gov/health-information-exchange-policy-issues
January 01, 2023 - This information is for reference purposes only. It was current when produced and may now be outdated. Archive material is no longer maintained, and some links may not work. Persons with disabilities having difficulty accessing this information should contact us at: https://digital.ahrq.gov/contact-us . Let us know th…
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psnet.ahrq.gov/innovation/system-approaches-social-determinants-health-screening-and-intervention-innovation
July 23, 2024 - System Approaches to Social Determinants of Health Screening and Intervention Innovation Summary
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September 23, 2024
View more articles from the same…
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integrationacademy.ahrq.gov/products/playbooks/moud-playbook/implementing-treatment/engaging-and-educating
January 01, 2024 - An official website of the Department of Health & Human Services
Search All AHRQ Sites
Careers
Contact Us
Español
FAQs
Email Updates
The Academy
Integrating Behavioral Health & Primary Care
Expand Navi…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/cusp/dailygoals-rounds-slides.pptx
January 01, 2017 - Module: Daily Goals During Interdisciplinary Rounds
Daily Goals During Interdisciplinary Rounds
AHRQ Safety Program for Mechanically Ventilated Patients
AHRQ Pub. No. 16(17)-0018-35-EF
January 2017
Daily Goals ‹#›
AHRQ Safety Program for Mechanically Ventilated Patients
1
Learning Objectives
After this sessio…
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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/professionals/systems/hospital/pressure_ulcer_prevention/module5/module5_pressureinjury-msmt_slides.pptx
June 02, 2025 - How To Measure Pressure Injury Rates and Prevention Practices
How To Measure
Pressure Injury Rates
and Prevention Practices
ADD Hospital Name Here
Module 5
1
Basic Quality Improvement Principle
If you can’t measure it, you can’t improve it.
2
2
Quality Improvement Principle
Pressure injury rates and preven…
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www.ahrq.gov/hai/cusp/toolkit/content-calls/org-embrace-slides/slides.html
June 01, 2013 - Organizational Embrace of CUSP to Improve Patient Safety (Slide Presentation)
On the CUSP: Stop BSI
This PowerPoint slide presentation was shown on March 20, 2012.
Contents
Slide 1. The Organizational Embrace of CUSP to Improve Patient Safety
Slide 2. Objectives
Slide 3. Speakers
Slide 4. Holy Cro…
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www.ahrq.gov/hai/cusp/modules/implement/teamwork.html
December 01, 2012 - Implement Teamwork and Communication
CUSP Toolkit
The Implement Teamwork and Communication module of the CUSP Toolkit will help you to identify barriers to communication.
Contents
Slide 1. Cover Slide
Slide 2. Learning Objectives
Slide 3. Basic Components and Process of Communication 2
Slide 4. Four…
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psnet.ahrq.gov/innovation/geisingers-outpatient-addiction-medicine-specialty-program-uses-data-driven-decision
October 30, 2024 - Geisinger’s Outpatient Addiction Medicine Specialty Program Uses Data-Driven Decision Making and MAT to Reduce Mortality Rates
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February 9, 2021
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www.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/community-pharmacy/measures-spanish.pdf
April 01, 2014 - Spanish Community Pharmacy Survey on Patient Safety Culture Items and Dimensions
Spanish Translation of AHRQ’s Community Pharmacy Survey on Patient Safety Culture
April 2014
This document explains the process that was used to develop a Spanish translation of the Agency for Healthcare
Research and Quality (AHRQ) C…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/medmanagement_webinar_slides.pdf
January 01, 2015 - Medication Management
1
Medication Management
AHRQ
Guide to Improving Patient Safety in Primary
Care Settings by Engaging Patients and
Families
Speaker
Kelly Smith, PhD
Scientific Director, Quality & Safety
Co-PI, AHRQ Guide to Improve Patient Safety
in Primary Care Settings by Engaging
Patients …
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www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-199-section-2-chart-tech-specs.pdf
January 01, 2013 - Section 2, Chart Abstraction Tool and Technical Specifications
Basic Elements
Age upon
Age upon admission
Patient ID Race Ethnicity Gender Payer
Preferred
Language
admission (YEARS)
[e.g. for 12.5 year
(MONTHS) [
e.g. for 12.5
old, years = 12) year old,
months = 6]
1 White Non-Hispanic Female Medicaid E…
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effectivehealthcare.ahrq.gov/sites/default/files/related_files/search-strategy-white-paper.pdf
February 01, 2025 - Processing of the search depends on the
length of the submitted text, for example a 350-word abstract
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hcup-us.ahrq.gov/db/nation/nis/APS-Def_Public_v24.pdf
March 01, 2008 - since the
methodology uses commonly available data and the software can be imbedded in
transaction processing
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psnet.ahrq.gov/issue/patient-doctor-continuity-and-diagnosis-cancer-electronic-medical-records-study-general
September 11, 2019 - Study
Patient–doctor continuity and diagnosis of cancer: electronic medical records study in general practice.
Citation Text:
Ridd MJ, Ferreira DLS, Montgomery AA, et al. Patient-doctor continuity and diagnosis of cancer: electronic medical records study in general practice. Br J Gen Pra…
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digital.ahrq.gov/ahrq-funded-projects/value-technology-transfer-discharge-information/annual-summary/2009
January 01, 2009 - Value of Technology to Transfer Discharge Information - 2009
Project Name
Value of Technology to Transfer Discharge Information
Principal Investigator
Graumlich, James
Organization
University of Illinois at Chicago
Funding Mechanism
RFA: HS04-012: Demonstrating the …