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1. Reducing delay in diagnosis: multistage recommendation tracking. | PSNet
   psnet.ahrq.gov/issue/reducing-delay-diagnosis-multistage-recommendation-tracking
   May 23, 2012 - Study Reducing delay in diagnosis: multistage recommendation tracking. … Reducing Delay in Diagnosis: Multistage Recommendation Tracking. … Reducing Delay in Diagnosis: Multistage Recommendation Tracking.

2. White paper on recommendation for systems-based practice competency. | PSNet
   psnet.ahrq.gov/issue/white-paper-recommendation-systems-based-practice-competency
   January 18, 2017 - Commentary White paper on recommendation for systems-based practice competency. … QSEN Institute RN-BSN Task Force: White Paper on Recommendation for Systems-Based Practice Competency … QSEN Institute RN-BSN Task Force: White Paper on Recommendation for Systems-Based Practice Competency

3. Implementing situation-background-assessment-recommendation in an anaesthetic clinic and subsequent information retention among receivers: a prospective interventional study of postoperative handovers. | PSNet
   psnet.ahrq.gov/issue/implementing-situation-background-assessment-recommendation-anaesthetic-clinic-and-subsequent
   February 12, 2014 - Study Implementing situation-background-assessment-recommendation in an anaesthetic … Implementing situation-background-assessment-recommendation in an anaesthetic clinic and subsequent information … The SBAR (situation-background-assessment-recommendation) method is commonly used to ensure high-quality … Implementing situation-background-assessment-recommendation in an anaesthetic clinic and subsequent information

4. Situation, background, assessment, recommendation (SBAR) communication tool for handoff in health care- a narrative review. | PSNet
   psnet.ahrq.gov/issue/situation-background-assessment-recommendation-sbar-communication-tool-handoff-health-care
   March 03, 2021 - Review Emerging Classic Situation, background, assessment, recommendation … Situation, Background, Assessment, Recommendation (SBAR) is a mnemonic used to structure information

5. Correlation between hospital rating agencies' data: an analysis and recommendation. | PSNet
   psnet.ahrq.gov/issue/correlation-between-hospital-rating-agencies-data-analysis-and-recommendation
   April 05, 2023 - Study Correlation between hospital rating agencies' data: an analysis and recommendation … Correlation between hospital rating agencies’ data: An analysis and recommendation. … Correlation between hospital rating agencies’ data: An analysis and recommendation.

6. Situation, background, assessment, and recommendation–guided huddles improve communication and teamwork in the emergency department. | PSNet
   psnet.ahrq.gov/issue/situation-background-assessment-and-recommendation-guided-huddles-improve-communication-and
   September 23, 2020 - Study Situation, background, assessment, and recommendation–guided huddles improve … Situation, Background, Assessment, and Recommendation-Guided Huddles Improve Communication and Teamwork … Situation, Background, Assessment, and Recommendation-Guided Huddles Improve Communication and Teamwork

7. Exploring the "Black Box" of recommendation generation in local health care incident investigations: a scoping review. | PSNet
   psnet.ahrq.gov/issue/exploring-black-box-recommendation-generation-local-health-care-incident-investigations
   November 16, 2016 - Review Exploring the "Black Box" of recommendation generation in local health care … Exploring the "Black Box" of recommendation generation in local health care incident investigations: … Exploring the "Black Box" of recommendation generation in local health care incident investigations:

8. Start using a checklist, PRONTO: recommendation for a standard review process for chemotherapy orders. | PSNet
   psnet.ahrq.gov/issue/start-using-checklist-pronto-recommendation-standard-review-process-chemotherapy-orders
   December 21, 2011 - Commentary Start using a checklist, PRONTO: recommendation for a standard review … Start using a checklist, PRONTO: Recommendation for a standard review process for chemotherapy orders … Start using a checklist, PRONTO: Recommendation for a standard review process for chemotherapy orders

9. Council recommendation on patient safety, including the prevention and control of healthcare associated infections. | PSNet
   psnet.ahrq.gov/issue/council-recommendation-patient-safety-including-prevention-and-control-healthcare-associated
   August 04, 2021 - Government Resource Council recommendation on patient safety, including the prevention

10. Mind the gap between recommendation and implementation—principles and lessons in the aftermath of incident investigations: a semi-quantitative and qualitative study of factors leading to the successful implementation of recommendations. | PSNet
    psnet.ahrq.gov/issue/mind-gap-between-recommendation-and-implementation-principles-and-lessons-aftermath-incident
    January 26, 2022 - Study Mind the gap between recommendation and implementation—principles and lessons … Mind the gap between recommendation and implementation—principles and lessons in the aftermath of incident … Mind the gap between recommendation and implementation—principles and lessons in the aftermath of incident … 2008 View More Related Resources Exploring the "Black Box" of recommendation

11. PSNet Curated Library (pdf file)
    psnet.ahrq.gov/print/pdf/node/848754
    January 01, 2023 - Mind the gap between recommendation and implementation—principles and lessons in the aftermath of incident … https://psnet.ahrq.gov/issue/mind-gap-between-recommendation-and-implementation-principles-and-lessons-aftermath-incident … https://psnet.ahrq.gov/issue/mind-gap-between-recommendation-and-implementation-principles-and-lessons-aftermath-incident … https://psnet.ahrq.gov/issue/mind-gap-between-recommendation-and-implementation-principles-and-lessons-aftermath-incident … Mind the gap between recommendation and implementation—principles and lessons in the aftermath of incident

12. Spotlight Case July 2008 (ppt file)
    psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.293_slideshow.ppt
    March 01, 2013 - interventions must exist to support accurate measurement, recording, and display of pediatric weights * Recommendation … Pediatrics. 2009;124:1233-1243. http://www.ncbi.nlm.nih.gov/pubmed/19770172 Recommendation #2 Because … * * Recommendation #3 Consider implementation of automated clinical decision support tools within … to expected weight in real-time to capture obvious discrepancies for the data-entry user * * Recommendation

13. Ambulatory Safety Nets to Reduce Missed and Delayed Diagnoses of Cancer | PSNet
    psnet.ahrq.gov/innovation/ambulatory-safety-nets-reduce-missed-and-delayed-diagnoses-cancer
    April 24, 2024 - Information technology registries, tools, and analytic capabilities to track each clinically necessary recommendation … The lung cancer safety net was constructed based on radiologist recommendation for follow-up imaging … radiology reports A lack of a harmonized radiology report 22 Variations in radiologist follow-up recommendation … One gap discovered by the team is how radiologists report and make recommendations, including what recommendation … CEBI team realized they needed systems to determine whether radiology reports contained a follow-up recommendation

14. Learning from Errors: Analysis of a Medication Error | PSNet
    psnet.ahrq.gov/training-catalog/learning-errors-analysis-medication-error
    case study approach to  analyze medication error events and discuss risk-mitigation strategies per recommendation

15. Managing Ascites: Hazards of Fluid Removal | PSNet
    psnet.ahrq.gov/web-mm/managing-ascites-hazards-fluid-removal
    August 31, 2022 - Otherwise, for patients with large ascites, the recommendation is to simply drain it, and drain it as … This recommendation is based on our early experience of a high incidence of infection when the draining … My personal recommendation is that albumin should be given at the end of paracentesis, rather than during … This recommendation is based on hemodynamic studies that we undertook 25 years ago ( 4 ), which observed

16. A Weighty Mistake | PSNet
    psnet.ahrq.gov/web-mm/weighty-mistake
    July 26, 2023 - Recommendation 1. … Recommendation 2. … This recommendation is also endorsed by the Institute for Safe Medication Practices.( 14 ) The challenges … Recommendation 3. … Recommendation 4.

17. Patient Safety Essentials Toolkit. | PSNet
    psnet.ahrq.gov/issue/patient-safety-essentials-toolkit
    January 08, 2020 - Featured tools include the Situation-Background-Assessment-Recommendation approach, huddle agendas, … September 3, 2016 Implementing situation-background-assessment-recommendation in an anaesthetic

18. SBAR improves communication and safety climate and decreases incident reports due to communication errors in an anaesthetic clinic: a prospective intervention study. | PSNet
    psnet.ahrq.gov/issue/sbar-improves-communication-and-safety-climate-and-decreases-incident-reports-due
    June 01, 2016 - Introduction of the SBAR (situation-background-assessment-recommendation) communication tool at two … Related Resources From the Same Author(s) Implementing situation-background-assessment-recommendation … September 21, 2016 Implementing situation-background-assessment-recommendation in an

19. Government Response to the Investigation into the Death of Elizabeth Dixon. | PSNet
    psnet.ahrq.gov/issue/government-response-investigation-death-elizabeth-dixon
    November 16, 2022 - This report sets out the government’s response to each recommendation, including the agency responsible … for each recommendation, where applicable.

20. Dynamic pocket card for implementing ISBAR in shift handover communication. | PSNet
    psnet.ahrq.gov/issue/dynamic-pocket-card-implementing-isbar-shift-handover-communication
    June 14, 2023 - Structured communication methods   such as SBAR (situation, background, assessment, recommendation) … or ISBAR (identify, situation, background, assessment, recommendation)  were developed to improve