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www.ahrq.gov/research/findings/final-reports/stpra/stpraapa2.html
April 01, 2018 - Proactive Risk Assessment of Surgical Site Infection in Ambulatory Surgery Centers
Appendix A, Pt. 2
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Table of Contents
Proactive Risk Assessment of Surgical Site Infection in Ambulatory Surgery Centers
Executive Summary
Chapter 1. Introduction
Chapter 2. ST-PRA Developm…
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effectivehealthcare.ahrq.gov/sites/default/files/pdf/methods-guidance-tests-bias_methods.pdf
July 01, 2012 - Methods Guide for Medical Test Reviews
5-1
Chapter 5
Assessing Risk of Bias as a Domain of Quality in
Medical Test Studies
P. Lina Santaguida, B.Sc.P.T., Ph.D., M.Sc., McMaster University
Crystal M. Riley, M.A., Nanyang Technological University, Singapore
David B. Matchar, M.D., Duke University;
Duke-…
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www.ahrq.gov/policymakers/hrqa99c.html
October 01, 2014 - Healthcare Research and Quality Act of 1999 (continued 2)
Text of the Act that reauthorizes the former Agency for Health Care Policy and Research, now the Agency for Healthcare Research and Quality (AHRQ).
PART C—GENERAL PROVISIONS SEC. 921. ADVISORY COUNCIL FOR HEALTHCARE RESEARCH AND QUALITY. (a) ESTABLISHM…
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psnet.ahrq.gov/node/45705/psn-pdf
January 23, 2017 - ASPEN Safe Practices for Enteral Nutrition Therapy.
January 23, 2017
Boullata JI, Carrera AL, Harvey L, et al. ASPEN Safe Practices for Enteral Nutrition Therapy. JPEN J
Parenter Enteral Nutr. 2017;41(1):15-103. doi:10.1177/0148607116673053.
https://psnet.ahrq.gov/issue/aspen-safe-practices-enteral-nutrition-therap…
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psnet.ahrq.gov/node/846164/psn-pdf
March 15, 2023 - Crowding in the Emergency Department: Challenges for
the Care of Children.
March 15, 2023
Gross TK, Lane NE, Timm NL, et al. Crowding in the Emergency Department: Challenges for the Care of
Children. Pediatrics. 2023;151(3):e2022060971-e2022060972. doi:10.1542/peds.2022-060971.
https://psnet.ahrq.gov/issue/crowdin…
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www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide68.html
October 01, 2014 - 68. For the Patient Willing To Quit (Continued)
Treating Tobacco Use and Dependence: 2008 Update
Text version of slide presentation.
Strategy A5. Arrange —Ensure follow-up contact
Action
Strategies for implementation
Arrange for follow-up contacts, either in person or via telephone
…
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psnet.ahrq.gov/node/45564/psn-pdf
October 03, 2017 - Fostering transparency in outcomes, quality, safety, and
costs.
October 3, 2017
Austin M, McGlynn EA, Pronovost P. Fostering Transparency in Outcomes, Quality, Safety, and Costs.
JAMA. 2016;316(16):1661-1662. doi:10.1001/jama.2016.14039.
https://psnet.ahrq.gov/issue/fostering-transparency-outcomes-quality-safety-a…
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psnet.ahrq.gov/node/852286/psn-pdf
August 09, 2023 - Guidelines on Human Factors in Critical Situations 2023.
August 9, 2023
Bijok B, Jaulin F, Picard J, et al. Guidelines on human factors in critical situations 2023. Anaesth Crit Care
Pain Med. 2023;42(4):101262. doi:10.1016/j.accpm.2023.101262.
https://psnet.ahrq.gov/issue/guidelines-human-factors-critical-situatio…
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psnet.ahrq.gov/node/73075/psn-pdf
March 24, 2021 - Analysis of transdermal medication patch errors
uncovers a “patchwork” of safety challenges.
March 24, 2021
ISMP Medication Safety Alert! Acute Care. March 11, 2021;26(5):1-6.
https://psnet.ahrq.gov/issue/analysis-transdermal-medication-patch-errors-uncovers-patchwork-safety-
challenges
Skin patches are a conveni…
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psnet.ahrq.gov/node/867639/psn-pdf
February 26, 2025 - Framing diagnostic error: an epidemiological perspective.
February 26, 2025
Hunter MK, Singareddy C, Mundt KA. Framing diagnostic error: an epidemiological perspective. Front
Public Health. 2024;12:1479750. doi:10.3389/fpubh.2024.1479750.
https://psnet.ahrq.gov/issue/framing-diagnostic-error-epidemiological-perspec…
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psnet.ahrq.gov/node/47601/psn-pdf
December 21, 2018 - Clinical decision support in the era of artificial
intelligence.
December 21, 2018
Shortliffe EH, Sepúlveda MJ. Clinical Decision Support in the Era of Artificial Intelligence. JAMA.
2018;320(21):2199-2200. doi:10.1001/jama.2018.17163.
https://psnet.ahrq.gov/issue/clinical-decision-support-era-artificial-intellige…
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psnet.ahrq.gov/node/45164/psn-pdf
May 25, 2016 - Eliminating Harm Checklists: Reduce All-Cause,
Preventable Harm.
May 25, 2016
Chicago, IL: American Hospital Association, Health Research & Educational Trust; 2016.
https://psnet.ahrq.gov/issue/eliminating-harm-checklists-reduce-all-cause-preventable-harm
Checklists are a recommended method to reduce omissions in …
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www.ahrq.gov/topics/childrens-health-insurance-program-reauthorization-act-chipra.html
Topic: Children's Health Insurance Program Reauthorization Act (CHIPRA)
Listing of content related to the topic Children's Health Insurance Program Reauthorization Act (CHIPRA)
Background Report for the Request for Public Comment on Initial, Recommended Core Set of Children…
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psnet.ahrq.gov/node/38317/psn-pdf
September 01, 2016 - Impact of non-interruptive medication laboratory
monitoring alerts in ambulatory care.
September 1, 2016
Lo HG, Matheny ME, Seger DL, et al. Impact of non-interruptive medication laboratory monitoring alerts in
ambulatory care. J Am Med Inform Assoc. 2009;16(1):66-71. doi:10.1197/jamia.M2687.
https://psnet.ahrq.go…
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psnet.ahrq.gov/node/48045/psn-pdf
June 05, 2019 - Obstetric practice guidelines: labor's love lost?
June 5, 2019
Cohen WR, Friedman EA. Obstetric practice guidelines: labor's love lost? J Matern Fetal Neonatal Med.
2019;32(9):1567-1570. doi:10.1080/14767058.2017.1406474.
https://psnet.ahrq.gov/issue/obstetric-practice-guidelines-labors-love-lost
Guidelines play a…
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psnet.ahrq.gov/node/46691/psn-pdf
December 06, 2017 - Improved Policies and Oversight Needed for Reviewing
and Reporting Providers for Quality and Safety Concerns.
December 6, 2017
Washington, DC: United States Government Accountability Office; November 2017. Publication GAO-18-
63.
https://psnet.ahrq.gov/issue/improved-policies-and-oversight-needed-reviewing-and-rep…
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psnet.ahrq.gov/node/73452/psn-pdf
June 30, 2021 - Administration of concentrated potassium chloride for
injection during a code: still deadly!
June 30, 2021
ISMP Medication Safety Alert! Acute care edition. June 3, 2021; 26(11): 1-5.
https://psnet.ahrq.gov/issue/administration-concentrated-potassium-chloride-injection-during-code-still-
deadly
Concentrated …
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psnet.ahrq.gov/node/47459/psn-pdf
October 10, 2018 - People, processes, health IT and accurate patient
identification.
October 10, 2018
Quick Safety. October 1, 2018;(45):1-2.
https://psnet.ahrq.gov/issue/people-processes-health-it-and-accurate-patient-identification
This newsletter article reviews common problems related to patient identification and recommends
st…
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psnet.ahrq.gov/node/43749/psn-pdf
December 10, 2014 - Alarm management: first things first: using reliable data
to eliminate unnecessary alarms.
December 10, 2014
Vanderveen T. Patient Saf Qual Healthc. November/December 2014;11:38-40,42-45.
https://psnet.ahrq.gov/issue/alarm-management-first-things-first-using-reliable-data-eliminate-unnecessary-
alarms
Spotlightin…
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psnet.ahrq.gov/node/35017/psn-pdf
August 24, 2017 - The Field Guide to Human Error Investigations, Third
Edition.
August 24, 2017
Dekker S. Boca Baton, FL: CRC Press; 2017.
https://psnet.ahrq.gov/issue/field-guide-human-error-investigations-third-edition
This revised and reorganized book provides a primer on how human error causes mishaps and often
illustrates dee…