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psnet.ahrq.gov/node/33605/psn-pdf
March 12, 2021 - Timing errors were also reduced by 27% in this study.
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psnet.ahrq.gov/web-mm/diagnostic-overshadowing-dangers
February 12, 2020 - A bedside echocardiogram revealed severely reduced left ventricular function with an akinetic inferior
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psnet.ahrq.gov/web-mm/diffusion-responsibility-leads-danger
November 08, 2013 - Coordination Center has led to improvement in ED throughput metrics, earlier discharge times, and has reduced
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/preventing-cauti-engaging-clinicians-051413.ppt
January 01, 2013 - Slide 1
Preventing CAUTI: Engaging Clinicians and Senior Leadership to Implement Change
*
Sanjay Saint, MD, MPH
M. Todd Greene, MPH, PhD
University of Michigan Medical School
Ann Arbor VA Medical Center
Learning Objectives
Describe the methods to engage clinicians in CAUTI prevention
Describe methods to engage l…
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integrationacademy.ahrq.gov/products/topic-briefs/emerging-best-practices-addressing-suicidality-primary-care
September 01, 2025 - coercive—can erode patient trust, discourage future help-seeking, and is not reliably associated with reduced … Contrary to common assumptions, involuntary psychiatric hospitalization is not reliably associated with reduced … of studies including over 3,500 participants found that Safety Planning Interventions significantly reduced … least six months and had frequent clinical touchpoints were significantly more likely to experience reduced
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol4/Keyes.pdf
January 01, 2004 - A Strategic Approach for Funding Research: The Agency for Healthcare Research and Quality’s Patient Safety Initiative 2000–2004
7
A Strategic Approach for Funding Research:
The Agency for Healthcare Research and
Quality’s Patient Safety Initiative 2000–2004
Margaret A. Keyes, Eduardo Ortiz, Deborah Queenan,
Ro…
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effectivehealthcare.ahrq.gov/sites/default/files/pdf/methods-guidance-bias_methods.pdf
February 01, 2013 - • Assessments of how this source of bias can be reduced, or even the magnitude of the bias,
are … speculate that the sensitivity of the process is increased although the specificity may be
somewhat reduced
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psnet.ahrq.gov/issue/side-tracks-safety-express-interruptions-lead-errors-and-unfinishedwait-what-was-i-doing
June 10, 2018 - Newspaper/Magazine Article
Side tracks on the safety express. Interruptions lead to errors and unfinished…wait, what was I doing?
Citation Text:
Side tracks on the safety express. Interruptions lead to errors and unfinished…wait, what was I doing? ISMP Medication Safety Alert! Acute care…
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www.ahrq.gov/news/newsroom/case-studies/201513.html
June 01, 2015 - Wisconsin Dialysis Centers Use AHRQ Toolkit to Reduce Infections
Search All Impact Case Studies
June 2015
The Purity Dialysis Center in Watertown, Wisconsin, achieved a 75 percent decline in healthcare-associated infections among dialysis patients after participating in an AHRQ-funded project that promotes …
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psnet.ahrq.gov/issue/eliminating-racial-and-ethnic-disparities-causing-mortality-and-morbidity-pregnant-and
December 23, 2016 - Sentinel Event Alerts
Eliminating racial and ethnic disparities causing mortality and morbidity in pregnant and postpartum patients.
Citation Text:
Eliminating racial and ethnic disparities causing mortality and morbidity in pregnant and postpartum patients. Sentinel Event Alert. January…
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psnet.ahrq.gov/issue/reducing-risk-designing-safer-shame-free-health-care-environment
September 29, 2017 - Book/Report
Reducing the Risk by Designing a Safer, Shame-free Health Care Environment.
Citation Text:
Reducing the Risk by Designing a Safer, Shame-free Health Care Environment. Abrams MA, Hung LL, Kashuba AB, et al. Chicago, IL: American Medical Association; 2007.
Copy Citation …
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psnet.ahrq.gov/issue/human-factors-and-medical-devices
July 31, 2012 - Multi-use Website
Human Factors and Medical Devices.
Citation Text:
Human Factors and Medical Devices. Center for Devices and Radiological Health, US Food and Drug Administration.
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psnet.ahrq.gov/issue/improving-diagnostic-quality-safetyreducing-diagnostic-error-measurement-considerations
November 20, 2019 - Book/Report
Improving Diagnostic Quality & Safety/Reducing Diagnostic Error: Measurement Considerations.
Citation Text:
Improving Diagnostic Quality & Safety/Reducing Diagnostic Error: Measurement Considerations. Washington DC; National Quality Forum: October 28, 2019.
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…
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psnet.ahrq.gov/issue/findings-two-inaugural-leapfrog-surveys-2019
November 06, 2019 - Book/Report
Findings of Two Inaugural Leapfrog Surveys 2019.
Citation Text:
Findings of Two Inaugural Leapfrog Surveys 2019. Washington DC: Leapfrog Group; 2019.
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psnet.ahrq.gov/issue/well-being-playbook-20-covid-19-resource-hospital-and-health-system-leaders
July 21, 2021 - Tools/Toolkit
Well-Being Playbook 2.0. A COVID-19 Resource for Hospital and Health System Leaders.
Citation Text:
Well-Being Playbook 2.0. A COVID-19 Resource for Hospital and Health System Leaders. AHA Physician Alliance. Chicago, IL: American Hospital Association. February 2021.
…
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psnet.ahrq.gov/node/36255/psn-pdf
February 02, 2011 - Interns' compliance with Accreditation Council for
Graduate Medical Education work-hour limits.
February 2, 2011
Landrigan CP, Barger LK, Cade BE, et al. Interns' compliance with accreditation council for graduate
medical education work-hour limits. JAMA. 2006;296(9):1063-70.
https://psnet.ahrq.gov/issue/interns-c…
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psnet.ahrq.gov/issue/medication-errors-emergency-department-need-pharmacy-involvement
August 12, 2020 - Newspaper/Magazine Article
Medication errors in the emergency department: need for pharmacy involvement?
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April 16, 2018
This piece…
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psnet.ahrq.gov/node/39670/psn-pdf
July 07, 2010 - The Power of Safety: State Reporting Provides Lessons in
Reducing Harm, Improving Care.
July 7, 2010
Washington DC: National Quality Forum; 2010.
https://psnet.ahrq.gov/issue/power-safety-state-reporting-provides-lessons-reducing-harm-improving-care
The landmark Institute of Medicine (IOM) report, To Err Is Human,…
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psnet.ahrq.gov/node/45585/psn-pdf
June 29, 2017 - Impact of Medicare's nonpayment program on hospital-
acquired conditions.
June 29, 2017
Thirukumaran CP, Glance LG, Temkin-Greener H, et al. Impact of Medicare's Nonpayment Program on
Hospital-acquired Conditions. Med Care. 2017;55(5):447-455. doi:10.1097/MLR.0000000000000680.
https://psnet.ahrq.gov/issue/impact-m…
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www.ahrq.gov/hai/quality/tools/cauti-ltc/how-to-use.html
March 01, 2017 - How To Use This Toolkit
Toolkit To Reduce CAUTI and Other HAIs in Long-Term Care Facilities
The toolkit consists of three sections. Your facility can use the materials in each section in improvement efforts to reduce CAUTI and other HAIs.
Implementation
Sustainability
Resources
Sections aggregate …