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Opioid Safety | PSNet

psnet.ahrq.gov/primer/opioid-safety

December 15, 2024 - As a result, most of the standard methods used to measure safety events did not detect these deaths … Policy interventions to reduce opioid prescribing include measures such as state-level prescription drug … monitoring programs, which allow prescribers to manage controlled substance utilization and identify … Affairs health system has achieved marked reductions in opioid prescribing through a comprehensive program … The Agency for Healthcare Research and Quality's Effective Health Care Program completed three reports

From theory to policy in resilient health care: policy recommendations and lessons learnt from the Resilience in Healthcare Research Program. | PSNet

psnet.ahrq.gov/issue/theory-policy-resilient-health-care-policy-recommendations-and-lessons-learnt-resilience

July 19, 2023 - resilient health care: policy recommendations and lessons learnt from the Resilience in Healthcare Research Program … resilient health care: policy recommendations and lessons learnt from the Resilience in Healthcare Research Program … The Resilience in Healthcare (RiH) Research Program is a large-scale, multi-country study of resilience … resilient health care: policy recommendations and lessons learnt from the Resilience in Healthcare Research Program … March 15, 2017 Developing a reliable and valid patient measure of safety in hospitals

National Priorities and Goals: Aligning Our Efforts to Transform America's Healthcare. | PSNet

psnet.ahrq.gov/issue/national-priorities-and-goals-aligning-our-efforts-transform-americas-healthcare

March 23, 2012 - Washington, DC: National Quality Forum; 2008. ISBN: 1933875194. … Washington, DC: National Quality Forum; 2008. ISBN: 1933875194. … This report resulted from a consensus program involving 28 national organizations that sought to outline … Washington, DC: National Quality Forum; 2008. ISBN: 1933875194. … August 2, 2017 Identification and Prioritization of Health IT Patient Safety Measures

Preventing wrong site, procedure, and patient events using a common cause analysis. | PSNet

psnet.ahrq.gov/issue/preventing-wrong-site-procedure-and-patient-events-using-common-cause-analysis

October 03, 2017 - These findings were used to implement systematic prevention measures. … 10, 2018 Navigating a ship with a broken compass: evaluating standard algorithms to measure … April 24, 2018 Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicator … 2017 What is the return on investment for implementation of a crew resource management program … View More See More About The Topic Operating Room Health Care Providers Quality

How useful are voluntary medication error reports? The case of warfarin-related medication errors. | PSNet

psnet.ahrq.gov/issue/how-useful-are-voluntary-medication-error-reports-case-warfarin-related-medication-errors

May 27, 2011 - Harmful medication errors in children: a 5-year analysis of data from the USP's MEDMARX(R) program … April 29, 2010 Medication therapy management programs: forming a new cornerstone for … quality and safety in Medicare. … May 11, 2017 Request for comments on the proposed measures and 2020 targets for the National … Action Plan for Adverse Drug Event Prevention: inpatient and outpatient measures for reduction of adverse

How U.S. teams advanced communication and resolution program adoption at local, state and national levels. | PSNet

psnet.ahrq.gov/issue/how-us-teams-advanced-communication-and-resolution-program-adoption-local-state-and-national

April 24, 2018 - Healthcare systems have implemented communication-and-resolution programs (CRPs) to respond and disclose … August 5, 2020 Developing a reliable and valid patient measure of safety in hospitals … June 25, 2014 Developing a patient measure of safety (PMOS). … June 18, 2013 Quality improvement and patient care checklists in intrahospital transfers … McDonald, MD, JD April 1, 2019 Can communication-and-resolution programs achieve

Measure Dx: implementing pathways to discover and learn from diagnostic errors. | PSNet

psnet.ahrq.gov/issue/measure-dx-implementing-pathways-discover-and-learn-diagnostic-errors

August 25, 2021 - Commentary Measure Dx: implementing pathways to discover and learn from diagnostic … Measure Dx: Implementing pathways to discover and learn from diagnostic errors. … This commentary introduces Measure Dx , a tool providing guidance for health care organizations to identify … Measure Dx: Implementing pathways to discover and learn from diagnostic errors. … November 18, 2020 A program to provide clinicians with feedback on their diagnostic performance

Errors in electronic health record–based data query of statin prescriptions in patients with coronary artery disease in a large, academic, multispecialty clinic practice. | PSNet

psnet.ahrq.gov/issue/errors-electronic-health-record-based-data-query-statin-prescriptions-patients-coronary

March 12, 2025 - Though electronic health record (EHR) data is not always accurate, federal pay-for-performance programs … March 12, 2025 Building the bridge to quality: an urgent call to integrate quality improvement … May 6, 2020 Association of the Hospital Readmissions Reduction Program implementation … August 28, 2019 Physicians' perspectives regarding prescription drug monitoring program … July 23, 2018 Electronic health record reviews to measure diagnostic uncertainty in primary

Surgeon-specific mortality data disguise wider failings in delivery of safe surgical services. | PSNet

psnet.ahrq.gov/issue/surgeon-specific-mortality-data-disguise-wider-failings-delivery-safe-surgical-services

March 09, 2022 - October 13, 2018 Effect of a quality improvement intervention with daily round checklists … August 16, 2017 The Safer Delivery of Surgical Services Program (S3): explaining its … differential effectiveness and exploring implications for improving quality in complex systems. … August 25, 2015 Composite measures for profiling hospitals on bariatric surgery performance … August 2, 2015 Association of hospital participation in a quality reporting program with

In Conversation with Patricia Dykes about The Ongoing Journey to Prevent Patient Falls | PSNet

psnet.ahrq.gov/perspective/conversation-patricia-dykes-about-ongoing-journey-prevent-patient-falls

December 18, 2024 - It is not enough just to say we are engaging the patient; we must be able to measure that. … I look at this as a process measure. Falls rates are outcome measures. … Process measures like patient engagement in the three-step fall prevention process are a good way to … have an intermediate measure of how well we are doing with fall prevention. … Patricia Dykes : Many hospitals have clinical ladder programs.

Factors associated with neuroradiologic diagnostic errors at a large tertiary-care academic medical center: a case-control study. | PSNet

psnet.ahrq.gov/issue/factors-associated-neuroradiologic-diagnostic-errors-large-tertiary-care-academic-medical

August 17, 2022 - Improvement Program and the American Geriatrics Society. … September 11, 2019 Using harm-based weights for the AHRQ Patient Safety for Selected … April 1, 2015 Recommendations from a national panel on quality improvement in obstetrics … October 18, 2023 Cross-Check QA: a quality assurance workflow to prevent missed diagnoses … October 4, 2023 Developing electronic clinical quality measures to assess the cancer

National Patient Safety Goals | PSNet

psnet.ahrq.gov/primer/national-patient-safety-goals

January 16, 2025 - The National Patient Safety Goals (NPSG) program was developed by The Joint Commission, a healthcare … The NPSG program aimed to provide a common improvement framework to enable organizations, especially … patient safety by using the NPSGs to identify their priorities for data collection, select metrics to measure … Measures Report. … and performance measures for improvement.

The safety of inpatient health care. | PSNet

psnet.ahrq.gov/issue/safety-inpatient-health-care

May 15, 2024 - May 15, 2024 Expert consensus on currently accepted measures of harm. … March 9, 2022 Implementation of the I-PASS handoff program in diverse clinical environments … Safety Innovations Patient and Family Centered I-PASS (Family-Centered Communication Program … September 28, 2022 The National Imperative to Improve Nursing Home Quality: Honoring … Eisenberg Patient Safety and Quality Awards.

Barriers and facilitators associated with the implementation of surgical safety checklists: a qualitative systematic review. | PSNet

psnet.ahrq.gov/issue/barriers-and-facilitators-associated-implementation-surgical-safety-checklists-qualitative

August 17, 2022 - information technology in residential aged care homes: an integrative review to identify service and quality … July 19, 2023 Implementation of the World Health Organization Trauma Care Checklist Program … in 11 centers across multiple economic strata: effect on care process measures. … Improving resident and fellow engagement in patient safety through a graduate medical education incentive program … Implementation of the Josie King Care Journal in a pediatric intensive care unit: a quality

Developing health care organizations that pursue learning and exploration of diagnostic excellence: an action plan. | PSNet

psnet.ahrq.gov/issue/developing-health-care-organizations-pursue-learning-and-exploration-diagnostic-excellence

October 28, 2020 - Download Citation Related Resources From the Same Author(s) A program … December 16, 2020 Developing electronic clinical quality measures to assess the cancer … April 26, 2023 Measure Dx: implementing pathways to discover and learn from … November 10, 2021 Preliminary study of patient safety and quality use cases for ICD-11 … September 29, 2017 View More See More About The Topic Quality and Safety

Continuous improvement as an ideal in health care. | PSNet

psnet.ahrq.gov/issue/continuous-improvement-ideal-health-care

August 04, 2021 - Two approaches to improving quality in health care are illustrated in this article. … The first, called quality by inspection , is a system based on the belief that quality is best achieved … November 30, 2016 COVID-19: patient safety and quality improvement skills to deploy during … August 10, 2022 The SAGES Fundamental Use of Surgical Energy program (FUSE): history, … November 9, 2016 Measures to improve diagnostic safety in clinical practice.

Patient self-medication--a change in hospital practice. | PSNet

psnet.ahrq.gov/issue/patient-self-medication-change-hospital-practice

March 09, 2022 - The investigators studied an inpatient safety medication program for 6 months and found that it helped … July 3, 2014 Measures of patient safety in developing and emerging countries: a review … March 23, 2011 Effect of a quality improvement intervention with daily round checklists … Annual Perspective Improving Diagnostic Safety and Quality … See More About The Topic Hospitals Nurses Nurse Managers Risk Managers Quality

Maternal Safety and Perinatal Mental Health | PSNet

psnet.ahrq.gov/perspective/maternal-safety-and-perinatal-mental-health

March 28, 2023 - As a part of its bundles, the AIM program highlights important data collection resources and measures … I currently work as the Senior Director for Quality Improvement and Programs at the American College … program. … These programs are focused on improving the quality of care and are highly integrated within the health … We can measure screening usually, but often we cannot measure whether a referral was actually followed

Periodic Issue | PSNet

psnet.ahrq.gov/periodic-issue/periodic-issue-469

December 31, 2024 - Standardized measures allow for comparison between facilities. … This article describes the development of a “Core Measures Set” that should be measured and reported … Subject-matter experts and patients agreed on 85 measures. … As one element of a national program to improve care quality, the Centers for Medicare and Medicaid Services … Patricia Dykes is the Program Director for Research at the Center for Patient Safety Research and Practice

Factors associated with workarounds in barcode-assisted medication administration in hospitals. | PSNet

psnet.ahrq.gov/issue/factors-associated-workarounds-barcode-assisted-medication-administration-hospitals

January 23, 2019 - Future quality improvement measures could focus on modifiable risk factors including nurse workload and … July 22, 2020 The effect of a transitional pharmaceutical care program on the occurrence … A quality improvement project and difference-in-difference analysis. … 2024 Annual Perspective Improving Diagnostic Safety and Quality … Nurses' shift length and overtime working in 12 European countries: the association with perceived quality

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