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psnet.ahrq.gov/issue/quality-measures-clinical-pharmacy-services-during-transitions-care
December 05, 2012 - Commentary
Quality measures of clinical pharmacy services during transitions of care.
Citation Text:
King PK, Burkhardt CDO, Rafferty A, et al. Quality measures of clinical pharmacy services during transitions of care. J Am Coll Clin Pharm. 2021;4(7):883-907. doi:10.1002/jac5.1479.
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www.ahrq.gov/research/findings/nhqrdr/chartbooks/carecoordination/carecoordination.html
June 01, 2018 - Chartbook on Care Coordination
Care Coordination
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Table of Contents
Chartbook on Care Coordination
Acknowledgments
Care Coordination
Trends in Care Coordination Measures
Transitions of Care
Preventable Emergency Department Visits
Potentially Avoidable Hospitalizati…
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psnet.ahrq.gov/issue/its-difference-between-life-and-death-views-professional-medical-interpreters-their-role
August 10, 2010 - Study
"It's the difference between life and death": the views of professional medical interpreters on their role in the delivery of safe care to patients with limited English proficiency.
Citation Text:
Wu MS, Rawal S. "It's the difference between life and death": The views of profession…
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www.ahrq.gov/news/newsroom/case-studies/cquips0901.html
October 01, 2014 - New York City Uses AHRQ Patient Safety Culture Survey to Reduce Patient Harm
Search All Impact Case Studies
November 2008
The New York City Health and Hospitals Corporation (HHC) has integrated the use of AHRQ's Hospital Survey on Patient Safety Culture as a core component of its corporate-wide patient sa…
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psnet.ahrq.gov/issue/potentially-inappropriate-prescribing-elderly-patients-2-outpatient-settings
November 18, 2009 - Study
Potentially inappropriate prescribing for elderly patients in 2 outpatient settings.
Citation Text:
Maio V, Hartmann CW, Poston S, et al. Potentially inappropriate prescribing for elderly patients in 2 outpatient settings. Am J Med Qual. 2006;21(3):162-8.
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psnet.ahrq.gov/issue/hospital-readmissions-physician-awareness-and-communication-practices
December 19, 2009 - Study
Classic
Hospital readmissions: physician awareness and communication practices.
Citation Text:
Roy CL, Kachalia A, Woolf S, et al. Hospital readmissions: physician awareness and communication practices. J Gen Intern Med. 2009;24(3):374-80. doi:10.1007/s1…
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psnet.ahrq.gov/issue/triangulating-case-finding-tools-patient-safety-surveillance-cross-sectional-case-study
February 08, 2012 - Study
Triangulating case-finding tools for patient safety surveillance: a cross-sectional case study of puncture/laceration.
Citation Text:
Taylor JA, Gerwin D, Morlock L, et al. Triangulating case-finding tools for patient safety surveillance: a cross-sectional case study of puncture/…
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psnet.ahrq.gov/issue/traditions-research-interruptions-healthcare-conceptual-review
April 19, 2017 - Review
Traditions of research into interruptions in healthcare: a conceptual review.
Citation Text:
McCurdie T, Sanderson P, Aitken LM. Traditions of research into interruptions in healthcare: A conceptual review. Int J Nurs Stud. 2017;66:23-36. doi:10.1016/j.ijnurstu.2016.11.005.
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psnet.ahrq.gov/issue/application-human-factors-classification-framework-patient-safety-identify-precursor-and
October 21, 2015 - Study
Application of a human factors classification framework for patient safety to identify precursor and contributing factors to adverse clinical incidents in hospital.
Citation Text:
Mitchell RJ, Williamson A, Molesworth B. Application of a human factors classification framework for p…
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psnet.ahrq.gov/issue/role-registered-nurses-error-prevention-discovery-and-correction
August 04, 2021 - Study
Role of registered nurses in error prevention, discovery and correction.
Citation Text:
Rogers AE, Dean GE, Hwang W-T, et al. Role of registered nurses in error prevention, discovery and correction. Qual Saf Health Care. 2008;17(2):117-21. doi:10.1136/qshc.2007.022699.
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psnet.ahrq.gov/issue/posthospital-medication-discrepancies-prevalence-and-contributing-factors
July 10, 2008 - Study
Classic
Posthospital medication discrepancies: prevalence and contributing factors.
Citation Text:
Coleman EA, Smith JD, Raha D, et al. Posthospital medication discrepancies: prevalence and contributing factors. Arch Intern Med. 2005;165(16):1842-1847.
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psnet.ahrq.gov/issue/evaluation-design-and-structure-electronic-medication-labels-improve-patient-health-knowledge
October 16, 2024 - Review
Evaluation of the design and structure of electronic medication labels to improve patient health knowledge and safety: a systematic review.
Citation Text:
Saif S, Bui TTT, Srivastava G, et al. Evaluation of the design and structure of electronic medication labels to improve patien…
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psnet.ahrq.gov/issue/comprehensive-obstetrics-patient-safety-program-improves-safety-climate-and-culture
October 20, 2014 - Study
A comprehensive obstetrics patient safety program improves safety climate and culture.
Citation Text:
Pettker CM, Thung SF, Raab CA, et al. A comprehensive obstetrics patient safety program improves safety climate and culture. Am J Obstet Gynecol. 2011;204(3):216.e1-6. doi:10.1016/…
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psnet.ahrq.gov/issue/safe-implementation-standard-concentration-infusions-paediatric-intensive-care
June 17, 2014 - Study
Safe implementation of standard concentration infusions in paediatric intensive care.
Citation Text:
Arenas-López S, Stanley IM, Tunstell P, et al. Safe implementation of standard concentration infusions in paediatric intensive care. Journal of Pharmacy and Pharmacology. 2016;69(5)…
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psnet.ahrq.gov/issue/tool-concise-analysis-patient-safety-incidents
August 09, 2018 - Study
A tool for the concise analysis of patient safety incidents.
Citation Text:
Pham JC, Hoffman C, Popescu I, et al. A Tool for the Concise Analysis of Patient Safety Incidents. Jt Comm J Qual Patient Saf. 2016;42(1):26-33.
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psnet.ahrq.gov/issue/identifying-resilience-system-safety-review-trauma-and-orthopaedic-theatres
October 19, 2011 - Commentary
Identifying resilience: a system safety review of trauma and orthopaedic theatres.
Citation Text:
Wills VE. Identifying resilience: a system safety review of trauma and orthopaedic theatres. Ergonomics. 2024;Epub Aug 9. doi:10.1080/00140139.2024.2343930.
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psnet.ahrq.gov/issue/prevalence-wrong-level-surgery-among-spine-surgeons
March 09, 2022 - Study
The prevalence of wrong level surgery among spine surgeons.
Citation Text:
Mody MG, Nourbakhsh A, Stahl DL, et al. The prevalence of wrong level surgery among spine surgeons. Spine (Phila Pa 1976). 2008;33(2):194-198. doi:10.1097/BRS.0b013e31816043d1.
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psnet.ahrq.gov/issue/promoting-effective-transitions-care-hospital-discharge-review-key-issues-hospitalists
November 16, 2022 - Review
Promoting effective transitions of care at hospital discharge: a review of key issues for hospitalists.
Citation Text:
Kripalani S, Jackson AT, Schnipper JL, et al. Promoting effective transitions of care at hospital discharge: a review of key issues for hospitalists. J Hosp Med. …
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psnet.ahrq.gov/issue/making-healthcare-safer-iii
March 27, 2019 - Book/Report
Making Healthcare Safer III.
Citation Text:
Making Healthcare Safer III. Holmes A, Long A, Wyant B, et al. Rockville, MD: Agency for Healthcare Research and Quality; March 2020. AHRQ Publication No. 20-0029-EF.
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psnet.ahrq.gov/issue/alliance-innovation-maternal-health-consensus-bundle-sepsis-obstetric-care
August 21, 2024 - Organizational Policy/Guidelines
Alliance for Innovation on Maternal Health: Consensus Bundle on Sepsis in Obstetric Care.
Citation Text:
Bauer ME, Albright C, Prabhu M, et al. Alliance for Innovation on Maternal Health: Consensus Bundle on Sepsis in Obstetric Care. Obstet Gynecol. 2023;…