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psnet.ahrq.gov/perspective/role-fda-ensuring-device-safety
May 28, 2020 - For the FDA, these modifications raise the question of how to ensure the long-term safety and effectiveness
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psnet.ahrq.gov/web-mm/lot-pain-medications
September 23, 2020 - Embedded in this question are issues relating to efficacy and safety; specifically, finding the right
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psnet.ahrq.gov/web-mm/hypoxic-gas-supply-cross-connected-pipelines
February 05, 2020 - Deaths from recreational abuse of nitrous oxide have also been reported in the literature and the question
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psnet.ahrq.gov/issue/can-communication-and-resolution-programs-achieve-their-potential-five-key-questions
September 01, 2018 - Commentary
Can communication-and-resolution programs achieve their potential? Five key questions.
Citation Text:
Gallagher TH, Mello MM, Sage WM, et al. Can Communication-And-Resolution Programs Achieve Their Potential? Five Key Questions. Health Aff (Millwood). 2018;37(11):1845-1852. do…
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psnet.ahrq.gov/issue/80-hour-duty-week-rationale-early-attitudes-and-future-questions
September 28, 2010 - Commentary
The 80-hour duty week: rationale, early attitudes, and future questions.
Citation Text:
Friedlaender GE. The 80-hour duty week: rationale, early attitudes, and future questions. Clin Orthop Relat Res. 2006;449:138-142.
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psnet.ahrq.gov/issue/surprising-way-stay-safe-hospital
January 20, 2021 - Newspaper/Magazine Article
The surprising way to stay safe in the hospital.
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January 14, 2015
This news article summarizes the resu…
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psnet.ahrq.gov/innovation/behavioral-health-vital-signs-initiative-increases-patient-education-and-disclosure
February 26, 2025 - “Behavioral Health Vital Signs” Initiative Increases Patient Education and Disclosure about Interpersonal Violence (IPV)
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June 30, 2021
Innovat…
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psnet.ahrq.gov/web-mm/missed-candor-implementation-opportunities
November 11, 2020 - Missed CANDOR Implementation Opportunities.
Citation Text:
Schweitzer L. Missed CANDOR Implementation Opportunities.. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2022.
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psnet.ahrq.gov/web-mm/spotlight-mistaken-attribution-diagnostic-misstep
July 01, 2011 - Medical stability should be viewed separately from the question of whether medical etiologies have been
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psnet.ahrq.gov/submit-innovations-landing
February 26, 2025 - Breadcrumb
Home
Improvement Resources
Innovations
Innovation Submissions
Individuals or organizations are encouraged to submit new or reimagined patient safety innovations that have been implemented, evaluated, sustained, and demonstrate significant improvement to patient safet…
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psnet.ahrq.gov/web-mm/under-pressure-delayed-diagnosis-compartment-syndrome-after-lower-leg-fracture
November 25, 2020 - Anyone responding affirmatively to a question receives a telephone call from a registered nurse trained
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psnet.ahrq.gov/perspective/safety-dentistry
August 01, 2016 - This question did not fill me with self-confidence, but it did spark an abiding curiosity about the safety
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psnet.ahrq.gov/web-mm/possible-probable-sure-wrong-premature-closure-and-anchoring-complicated-case
October 02, 2013 - ; (vi) to what extent would additional diagnostic tests help resolve this question?
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psnet.ahrq.gov/node/33575/psn-pdf
March 15, 2025 - Patient Engagement and Safety
March 15, 2025
Patient Engagement and Safety. PSNet [internet]. 2019.
https://psnet.ahrq.gov/primer/patient-engagement-and-safety
PSNet primers are regularly reviewed and updated by the UC Davis PSNet Editorial Team to ensure that
they reflect current research and practice in the pati…
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psnet.ahrq.gov/issue/independent-double-checks-worth-effort-if-used-judiciously-and-properly
January 23, 2019 - Newspaper/Magazine Article
Independent double checks: worth the effort if used judiciously and properly.
Citation Text:
Independent double checks: worth the effort if used judiciously and properly. ISMP Medication Safety Alert! Acute Care Edition. June 6, 2019;24:1-7.
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psnet.ahrq.gov/basic-page/ucd-cmeceu-trainee-certification
November 01, 2019 - University of California, Davis, Health CME/CEU Information
WebM&M Spotlight cases on AHRQ’s PSNet offer CME/CEU and Maintenance of Certification (MOC) credit. Effective November 2019, each Spotlight Case and Commentary is certified for the AMA PRA Category 1 ™and maintenance of certification (MOC) through the Amer…
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psnet.ahrq.gov/perspective/where-does-risk-adjusted-mortality-fit-safety-measurement-program
March 01, 2015 - BJ : Well, that's a good question. I was more optimistic after Mid Staffs.
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psnet.ahrq.gov/perspective/building-safety-program-vast-health-care-network
March 01, 2019 - One question that people suggested to us and we incorporated was, "How are department chairs chosen?"
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psnet.ahrq.gov/perspective/resilient-healthcare-and-safety-i-and-safety-ii-frameworks
December 14, 2022 - The question of “What went well?”
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psnet.ahrq.gov/web-mm/challenges-diabetes-management-and-medication-reconciliation
March 15, 2023 - Challenges of Diabetes Management and Medication Reconciliation
Citation Text:
Lee S, Molla M. Challenges of Diabetes Management and Medication Reconciliation . PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2022.
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