-
digital.ahrq.gov/sites/default/files/HDPM%20App%20Assessment%20Report_Final.pdf
April 01, 2022 - requires reliance on local codes and proprietary mappings, as
was required in our implementation, which reduces
-
effectivehealthcare.ahrq.gov/sites/default/files/pdf/asthma-immunotherapy_research-protocol.pdf
September 14, 2016 - SCIT can be effective in reducing asthma symptoms and medication use and SLIT in the
aqueous form reduces
-
www.ahrq.gov/sites/default/files/wysiwyg/data/infographics/hac-rates-decline.pdf
June 02, 2025 - Declines in Hospital Acquired Conditions
Declines in Hospital-
Acquired Conditions
National efforts to reduce hospital-acquired conditions such
as adverse drug events and injuries from falls helped prevent
8,000 deaths and saved $2.9 billion between 2014 and 2016.
Adverse
Drug
Events CAUTI*
*CAUTI - Catheter-…
-
psnet.ahrq.gov/node/48190/psn-pdf
June 17, 2024 - APSF Stoelting Conference.
June 17, 2024
Anesthesia Patient Safety Foundation. Markell Conference Center, Somerville, MA, September 4–5, 2024.
https://psnet.ahrq.gov/issue/apsf-stoelting-conference
Anesthesia is a high-risk activity that has achieved safety successes. This hybrid conference explored
topics related…
-
digital.ahrq.gov/ahrq-funded-projects/success-stories/text-messaging-managing-chronic-disease
January 01, 2023 - Text Messaging for Managing Chronic Disease
Your browser does not support inline frames. Please go to http://youtu.be/bpP8xawfoi4 to view the video. Principal Investigator: Jennifer Uhrig (Contract No. HHSA290200600001I #7) [5 min., 10 sec.] This project showed that text messaging can effec…
-
www.ahrq.gov/practiceimprovement/systemdesign/leancasestudies/lean-exhibit3-15.html
November 01, 2014 - Improving Care Delivery Through Lean: Implementation Case Studies
Exhibit 3.15. Hip and Knee Replacement
Previous Page Next Page
Table of Contents
Improving Care Delivery Through Lean: Implementation Case Studies
Introduction to the Case Studies
Case 1. Lakeview Healthcare
Case 2. Central Hosp…
-
psnet.ahrq.gov/node/41075/psn-pdf
January 18, 2012 - Wide heart monitor use tied to missed alarms.
January 18, 2012
Funk M, Winkler CG, May JL, et al. Unnecessary arrhythmia monitoring and underutilization of ischemia
and QT interval monitoring in current clinical practice: baseline results of the Practical Use of the Latest
Standards for Electrocardiography trial. J…
-
psnet.ahrq.gov/node/38822/psn-pdf
July 29, 2009 - The 5th anniversary of the "Universal Protocol": pitfalls
and pearls revisited.
July 29, 2009
Stahel PF, Mehler PS, Clarke TJ, et al. The 5th anniversary of the "Universal Protocol": pitfalls and pearls
revisited. Patient Saf Surg. 2009;3(1):14. doi:10.1186/1754-9493-3-14.
https://psnet.ahrq.gov/issue/5th-annivers…
-
psnet.ahrq.gov/node/42447/psn-pdf
July 24, 2013 - Economic Analysis of Medical Malpractice Liability and Its
Reform.
July 24, 2013
Arlen J. New York, NY: New York University School of Law; May 9, 2013. Public Law Research Paper No.
13-25.
https://psnet.ahrq.gov/issue/economic-analysis-medical-malpractice-liability-and-its-reform
This report describes a ma…
-
psnet.ahrq.gov/node/38530/psn-pdf
April 01, 2009 - Assessing the impact of an educational program on
decreasing prescribing errors at a university hospital.
April 1, 2009
Peeters MJ, Pinto SL. Assessing the impact of an educational program on decreasing prescribing errors at
a university hospital. J Hosp Med. 2009;4(2):97-101. doi:10.1002/jhm.387.
https://psnet.ah…
-
psnet.ahrq.gov/node/44226/psn-pdf
November 03, 2015 - The Patient Survival Handbook.
November 3, 2015
Powell SM, Stone RD. Peachtree City, GA: Synensis; 2015.
https://psnet.ahrq.gov/issue/patient-survival-handbook
Engaging patients in their care is increasingly advocated as a way to improve safety. This book
recommends actions for patients and families to reduce risk…
-
psnet.ahrq.gov/node/45291/psn-pdf
November 30, 2016 - Just Bag It.
November 30, 2016
National Comprehensive Cancer Network.
https://psnet.ahrq.gov/issue/just-bag-it
Vincristine is a chemotherapy agent that can have serious consequences if administered incorrectly.
Drawing from guidelines and expert opinion regarding vincristine administration, this campaign advocates…
-
psnet.ahrq.gov/node/73173/psn-pdf
April 21, 2021 - Racism and Health.
April 21, 2021
Centers for Disease Control and Prevention.
https://psnet.ahrq.gov/issue/racism-and-health
Ethnic and social inequities have a substantial impact on the safety and effectiveness of health care. This
US Centers for Disease Control and Prevention (CDC) initiative provides access to …
-
psnet.ahrq.gov/node/72863/psn-pdf
March 17, 2021 - 7 ways to prevent medical errors.
March 17, 2021
Caceres V. US News World Report. March 1, 2021.
https://psnet.ahrq.gov/issue/7-ways-prevent-medical-errors
Patients and families have an important role in reducing potential for error and harm. This article highlights
a set of tactics for patients to enhan…
-
psnet.ahrq.gov/node/42975/psn-pdf
February 26, 2014 - State-Wide Initiative to Standardize the Compounding of
Oral Liquids in Pediatrics.
February 26, 2014
Michigan Pharmacists Association; MPA.
https://psnet.ahrq.gov/issue/state-wide-initiative-standardize-compounding-oral-liquids-pediatrics
Children are often prescribed oral liquid medications due to difficulty swa…
-
psnet.ahrq.gov/node/43233/psn-pdf
June 17, 2014 - Quality and safety education for nurses: a nursing
leadership skills exercise.
June 17, 2014
Harrison EM. Quality and safety education for nurses: a nursing leadership skills exercise. J Nurs Educ.
2014;53(6):356-361. doi:10.3928/01484834-20140512-01.
https://psnet.ahrq.gov/issue/quality-and-safety-education-nurse…
-
psnet.ahrq.gov/node/44613/psn-pdf
October 28, 2015 - Getting rid of "never events" in hospitals.
October 28, 2015
Morgenthaler T; Harper CM.
https://psnet.ahrq.gov/issue/getting-rid-never-events-hospitals
Never events are devastating and preventable, and health care organizations are under increasing
pressure to eliminate them. This commentary discusses how the Mayo…
-
psnet.ahrq.gov/node/37413/psn-pdf
November 14, 2011 - Patient Safety Tools: Improving Safety at the Point of
Care.
November 14, 2011
https://psnet.ahrq.gov/issue/patient-safety-tools-improving-safety-point-care-0
Produced in conjunction with its Partnerships in Implementing Patient Safety (PIPS) grant program,
AHRQ has released 17 freely available toolkits to help ho…
-
psnet.ahrq.gov/node/41506/psn-pdf
October 12, 2012 - Preventable errors in organ transplantation: an emerging
patient safety issue?
October 12, 2012
Ison MG, Holl JL, Ladner D. Preventable errors in organ transplantation: an emerging patient safety issue?
Am J Transplant. 2012;12(9):2307-12. doi:10.1111/j.1600-6143.2012.04139.x.
https://psnet.ahrq.gov/issue/preventa…
-
psnet.ahrq.gov/node/37788/psn-pdf
May 28, 2008 - Durable improvements in efficiency, safety, and
satisfaction in the operating room.
May 28, 2008
Heslin MJ, Doster BE, Daily SL, et al. Durable improvements in efficiency, safety, and satisfaction in the
operating room. J Am Coll Surg. 2008;206(5):1083-9; discussion 1089-90.
doi:10.1016/j.jamcollsurg.2008.02.006.
…