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4461. Background Report for the Request for Public Comment on Initial, Recommended Core Set of Children's Healthcare Quality Measures for Voluntary Use by Medicaid and CHIP Programs | Agency for Healthcare Research and Quality
      www.ahrq.gov/policymakers/chipra/overview/background/appendix-a4.html
      December 01, 2009 - Background Report for the Request for Public Comment on Initial, Recommended Core Set of Children's Healthcare Quality Measures for Voluntary Use by Medicaid and CHIP Programs Background Report on request for public comment on initial, recommended core set of Children's Healthcare Quality Measures for voluntary…

4462. Background Report for the Request for Public Comment on Initial, Recommended Core Set of Children's Healthcare Quality Measures for Voluntary Use by Medicaid and CHIP Programs | Agency for Healthcare Research and Quality
      www.ahrq.gov/policymakers/chipra/overview/background/appendix-a5.html
      December 01, 2009 - Background Report for the Request for Public Comment on Initial, Recommended Core Set of Children's Healthcare Quality Measures for Voluntary Use by Medicaid and CHIP Programs Background Report on request for public comment on initial, recommended core set of Children's Healthcare Quality Measures for voluntary…

4463. Talent Release Form (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/research/publications/pubcomguide/Talent-Release-fillable-form.pdf
      April 01, 2024 - Talent Release Form Talent Release Form Instructions This Talent Release Form must be completed by nongovernment people hired as narrators, actors, extras, or models for a scripted video, audio recording, or photo session. This includes paid and unpaid talent – anyone who will be recognizable in the fina…

4464. Analysis of ISMP National Vaccine Errors Reporting Program—part 1 and part 2. | PSNet
      psnet.ahrq.gov/issue/analysis-ismp-national-vaccine-errors-reporting-program-part-1-and-part-2
      July 08, 2015 - Newspaper/Magazine Article Analysis of ISMP National Vaccine Errors Reporting Program—part 1 and part 2. Citation Text: Analysis of ISMP National Vaccine Errors Reporting Program—part 1 and part 2. ISMP Medication Safety Alert! Acute Care Edition. December 4, 2014;19:1-6. March 26, 2015;…

4465. Drawn curtains, muted alarms, and diverted attention lead to tragedy in the postanesthesia care unit. | PSNet
      psnet.ahrq.gov/issue/drawn-curtains-muted-alarms-and-diverted-attention-lead-tragedy-postanesthesia-care-unit
      June 10, 2018 - Newspaper/Magazine Article Drawn curtains, muted alarms, and diverted attention lead to tragedy in the postanesthesia care unit. Citation Text: Drawn curtains, muted alarms, and diverted attention lead to tragedy in the postanesthesia care unit. ISMP Medication Safety Alert! Acute Care E…

4466. Tubing misconnections—a persistent and potentially deadly occurrence. | PSNet
      psnet.ahrq.gov/issue/tubing-misconnections-persistent-and-potentially-deadly-occurrence
      March 14, 2018 - Newspaper/Magazine Article Tubing misconnections—a persistent and potentially deadly occurrence. Citation Text: Organizations USAJC on A of H. Tubing misconnections--a persistent and potentially deadly occurrence. Sentinel event alert. 2006;(36):1-3. Copy Citation Format: G…

4467. Full disclosure and apology—an idea whose time has come. | PSNet
      psnet.ahrq.gov/issue/full-disclosure-and-apology-idea-whose-time-has-come
      November 02, 2014 - Newspaper/Magazine Article Full disclosure and apology—an idea whose time has come. Citation Text: Leape L. Full disclosure and apology--an idea whose time has come. Physician Exec. 2006;32(2):16-18. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNot…

4468. Cognitive Load Theory and its Impact on Diagnostic Accuracy. | PSNet
      psnet.ahrq.gov/issue/cognitive-load-theory-and-its-impact-diagnostic-accuracy
      August 07, 2024 - Book/Report Cognitive Load Theory and its Impact on Diagnostic Accuracy. Citation Text: Cognitive Load Theory and its Impact on Diagnostic Accuracy. Knees M, Raffel KE, Kissler M, et al. Rockville, MD: Agency for Healthcare Research and Quality; May 2024. Publication No. 24-0010-2-EF. …

4469. Enteral feeding misconnections: a consortium position statement. | PSNet
      psnet.ahrq.gov/issue/enteral-feeding-misconnections-consortium-position-statement
      June 17, 2009 - Organizational Policy/Guidelines Enteral feeding misconnections: a consortium position statement. Citation Text: Guenter P, Hicks RW, Simmons D, et al. Enteral feeding misconnections: a consortium position statement. Jt Comm J Qual Patient Saf. 2008;34(5):285-92, 245. Copy Citation …

4470. Group urges going metric to head off dosing mistakes. | PSNet
      psnet.ahrq.gov/issue/group-urges-going-metric-head-dosing-mistakes
      December 19, 2017 - Commentary Group urges going metric to head off dosing mistakes. Citation Text: Budnitz DS, Lovegrove MC, Rose KO. Adherence to Label and Device Recommendations for Over-the-Counter Pediatric Liquid Medications. PEDIATRICS. 2014;133(2). doi:10.1542/peds.2013-2362. Copy Citation For…

4471. A Prototype Computerized Provider Order Entry System Reduced Medication Errors | Digital Healthcare Research
      digital.ahrq.gov/2018-year-review/research-spotlights/prototype-computerized-provider-order-entry-system-reduced
      January 01, 2018 - A Prototype Computerized Provider Order Entry System Reduced Medication Errors Key Finding and Impact A prototype CPOE was developed that allowed providers to record medication indications and showed them the drug of choice for that indication. Providers testing the prototype CPOE correctly placed medication …

4472. AHRQ-Funded Research Supports Clinicians’ Work | Digital Healthcare Research
      digital.ahrq.gov/2018-year-review/research-summary/supports-clinicians-work
      January 01, 2018 - AHRQ-Funded Research Supports Clinicians’ Work Research funded by AHRQ aims to support clinicians and other healthcare professionals in providing health services. The projects highlighted below share the goal of improving the experience of health professionals who use health IT. The fe…

4473. Examining the Relationship Between Health IT and Ambulatory Care Workflow Redesign. | PSNet
      psnet.ahrq.gov/issue/examining-relationship-between-health-it-and-ambulatory-care-workflow-redesign
      December 24, 2008 - Book/Report Examining the Relationship Between Health IT and Ambulatory Care Workflow Redesign. Citation Text: Examining the Relationship Between Health IT and Ambulatory Care Workflow Redesign. Zheng K, Ciemins EL, Lanham HJ, et al. Rockville, MD: Agency for Healthcare Research and Qual…

4474. Twelve best practices for team training evaluation in health care. | PSNet
      psnet.ahrq.gov/issue/twelve-best-practices-team-training-evaluation-health-care
      July 02, 2014 - Commentary Twelve best practices for team training evaluation in health care. Citation Text: Weaver SJ, Salas E, King HB. Twelve best practices for team training evaluation in health care. Jt Comm J Qual Patient Saf. 2011;37(8):341-9. Copy Citation Format: Google Scholar …

4475. AHRQ_Brand_NameOnly (doc file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/sustainability/sustainability-workplan.docx
      January 01, 2017 - AHRQ Safety Program for Mechanically Ventilated Patients Annual Sustainability Work Plan Caring for Mechanically Ventilated Patients Year ______________ Hospital Name ________________________________________ Unit ___________________________ This Sustainability Plan template is designed to help you sustain your eff…

4476. When good doctors go bad: a systems problem. | PSNet
      psnet.ahrq.gov/issue/when-good-doctors-go-bad-systems-problem
      November 02, 2014 - Commentary When good doctors go bad: a systems problem. Citation Text: Leape L. When good doctors go bad: a systems problem. Ann Surg. 2006;244(5):649-652. Copy Citation Format: Google Scholar PubMed BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubMedId RIS …

4477. Public Health Notification from FDA: Vail Products Enclosed Bed Systems. | PSNet
      psnet.ahrq.gov/issue/public-health-notification-fda-vail-products-enclosed-bed-systems
      December 16, 2020 - Press Release/Announcement Public Health Notification from FDA: Vail Products Enclosed Bed Systems. Citation Text: Public Health Notification from FDA: Vail Products Enclosed Bed Systems. MedWatch Safety Alert. Rockville, MD: US Food and Drug Administration; December 4, 2007. Copy …

4478. Patient safety systems for case management. | PSNet
      psnet.ahrq.gov/issue/patient-safety-systems-case-management
      December 22, 2008 - Review Patient safety systems for case management. Citation Text: Greenberg L. Patient safety systems for case management. Lippincotts Case Manag. 2004;9(5):223-229. doi:10.1097/00129234-200409000-00004. Copy Citation Format: DOI Google Scholar BibTeX EndNote X3 XML EndNo…

4479. Patient Safety Investigation report into services at University Hospital Galway (UHG) and as reflected in the care provided to Savita Halappanavar. | PSNet
      psnet.ahrq.gov/issue/patient-safety-investigation-report-services-university-hospital-galway-uhg-and-reflected
      June 14, 2017 - Book/Report Patient Safety Investigation report into services at University Hospital Galway (UHG) and as reflected in the care provided to Savita Halappanavar. Citation Text: Patient Safety Investigation report into services at University Hospital Galway (UHG) and as reflected in the ca…

4480. Some IV medications are diluted unnecessarily in patient care areas, creating undue risk. | PSNet
      psnet.ahrq.gov/issue/some-iv-medications-are-diluted-unnecessarily-patient-care-areas-creating-undue-risk
      June 18, 2014 - Newspaper/Magazine Article Some IV medications are diluted unnecessarily in patient care areas, creating undue risk. Citation Text: Some IV medications are diluted unnecessarily in patient care areas, creating undue risk. ISMP Medication Safety Alert! Acute Care Edition. June 19, 2014;19…