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psnet.ahrq.gov/node/33782/psn-pdf
March 01, 2015 - with elevated HSMRs, no differences were seen compared to hospitals
with lower HSMRs in adherence rates … Unfavorable
rates arising from erroneous data or analyses can trigger external inquiries that stigmatize … Comparison of hospital risk-standardized mortality rates
calculated by using in-hospital and 30-day … Variability in the measurement of hospital-wide
mortality rates. N Engl J Med. 2010;363:2530-2539. … What is the empirical evidence that hospitals with higher risk-
adjusted mortality rates provide poor
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psnet.ahrq.gov/node/37510/psn-pdf
March 04, 2011 - rare-adverse-medical-events-va-inpatient-care-reliability-limits-using-patient-
safety
This study assessed the value of AHRQ Patient Safety Indicator (PSI) rates … evaluating-patient-safety-indicators-how-well-do-they-perform-veterans-health-administration
https://psnet.ahrq.gov/issue/tracking-rates-patient-safety-indicators-over-time-lessons-veterans-administration
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psnet.ahrq.gov/node/42087/psn-pdf
March 06, 2013 - attempted to replicate the Keystone study in 223 ICUs in England, yielded a surprising result: infection
rates … significantly in both control and intervention hospitals, likely reflecting secular trends in
infection rates
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psnet.ahrq.gov/node/35889/psn-pdf
March 10, 2011 - study determined that an automated adverse drug event (ADE) surveillance system captured higher
event rates … Not only did the system detect ADEs at higher rates
in the community setting, but the specific events
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psnet.ahrq.gov/node/47283/psn-pdf
January 27, 2019 - No impact
was found on overall opioid prescribing rates. … recent state-level analysis found that states who
implemented a PDMP had lower opioid prescribing rates
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psnet.ahrq.gov/node/39233/psn-pdf
August 02, 2013 - Although RRS usage was associated with decreased cardiac arrest
rates on general wards, overall mortality … rates did not improve, and the review noted significant problems
with the methodological quality of
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psnet.ahrq.gov/node/33928/psn-pdf
June 23, 2015 - This study examines those claims by conducting a literature review of anesthesia-
related mortality rates … Results from aggregate data, as well as mortality rates
determined by peer review, suggest that, contrary
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psnet.ahrq.gov/perspective/playing-well-others-translocational-research-patient-safety
September 01, 2005 - High rates of adverse drug events in a highly computerized hospital.
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psnet.ahrq.gov/node/852700/psn-pdf
August 30, 2023 - we had made progress prior to the pandemic, in the United States, we have since
experienced higher rates
-
psnet.ahrq.gov/issue/decreasing-handoff-related-care-failures-childrens-hospitals
April 24, 2018 - August 4, 2021
Temporal trends in rates of patient harm resulting from medical care. … April 26, 2023
Effect of Patient and Family Centered I-PASS on adverse event rates … August 15, 2016
Rates of medical errors and preventable adverse events among hospitalized
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psnet.ahrq.gov/web-mm/transfusion-thresholds-gastrointestinal-bleeding
November 26, 2014 - SPOTLIGHT CASE
Transfusion Thresholds in Gastrointestinal Bleeding
Citation Text:
Strate L, Swanson S. Transfusion Thresholds in Gastrointestinal Bleeding. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2017.
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psnet.ahrq.gov/web-mm/silent-pain-neck
August 19, 2020 - Silent Pain in the Neck
Citation Text:
Bittner EA. Silent Pain in the Neck. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2011.
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Format:
Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged Pu…
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psnet.ahrq.gov/web-mm/language-barrier
February 28, 2024 - Language Barrier
Citation Text:
Flores G. Language Barrier. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2006.
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…
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psnet.ahrq.gov/web-mm/central-line-clot
August 04, 2021 - SPOTLIGHT CASE
Central Line Clot
Citation Text:
Randolph AG. Central Line Clot. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2003.
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-
psnet.ahrq.gov/node/73455/psn-pdf
June 30, 2021 - Paroxysmal Supraventricular Tachycardia Masquerading
as Panic Attacks
June 30, 2021
Martin DT, O’Leary D. Paroxysmal Supraventricular Tachycardia Masquerading as Panic Attacks. PSNet
[internet]. 2021.
https://psnet.ahrq.gov/web-mm/paroxysmal-supraventricular-tachycardia-masquerading-panic-attacks
The Case
At the…
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psnet.ahrq.gov/web-mm/more-treatment-better-care
August 11, 2021 - More Treatment—Better Care?
Citation Text:
Redberg R. More Treatment—Better Care?. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2011.
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psnet.ahrq.gov/web-mm/undetected-foreign-object
April 24, 2018 - Undetected Foreign Object
Citation Text:
Cima RR. Undetected Foreign Object. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2012.
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psnet.ahrq.gov/sites/default/files/2019-11/webmm_spotlight_suicide_risk_assessment.pdf
January 01, 2019 - Spotlight
Missed Opportunities for Suicide
Risk Assessment
Source and Credits
• This presentation is based on the November 2019 AHRQ WebM&M
Spotlight Case
○ See the full article at https://psnet.ahrq.gov/webmm
○ CME credit is available
• Commentary by: Glen Xiong, MD & Debra Kahn, MD
○ Editors in Chief, AHRQ We…
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psnet.ahrq.gov/web-mm/july-syndrome
July 01, 2011 - July Syndrome
Citation Text:
Young JQ. July Syndrome. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2016.
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D…
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psnet.ahrq.gov/web-mm/delayed-recognition-positive-blood-culture
January 29, 2020 - Delayed Recognition of a Positive Blood Culture
Citation Text:
Doernberg S. Delayed Recognition of a Positive Blood Culture. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2017.
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