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psnet.ahrq.gov/web-mm/discharge-fumbles
September 09, 2009 - characteristics that identify patients at high risk for errors at discharge Understand the provider's role in reducing
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psnet.ahrq.gov/node/49816/psn-pdf
January 01, 2018 - Treatment is critical for reducing the adverse health, social, and other consequences of alcohol use
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psnet.ahrq.gov/web-mm/diagnosing-missed-diagnosis
October 26, 2022 - plan should the initial plan prove ineffective or incorrect) Giving feedback Simulation Reducing
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psnet.ahrq.gov/node/49694/psn-pdf
October 01, 2013 - The World Health Organization (WHO) and The Joint Commission have
recommended strategies for reducing
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psnet.ahrq.gov/innovation/team-developed-care-plan-and-ongoing-care-management-social-workers-and-nurse
July 23, 2024 - preventative care and management services through this program has shown to improve patient outcomes, such reducing … Best bets for reducing Medicare costs for dual eligible beneficiaries: assessing the evidence.
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psnet.ahrq.gov/node/39589/psn-pdf
February 13, 2018 - Common cause analysis.
February 13, 2018
Clapper C, Crea K. Patient Saf Qual Healthc. May/June 2010;7:30-35.
https://psnet.ahrq.gov/issue/common-cause-analysis
This article describes how one health care system used a multi-event analysis process to identify
medication errors, implement system-level improvements, a…
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psnet.ahrq.gov/node/41471/psn-pdf
June 20, 2012 - Patients taking their own medications while in the
hospital.
June 20, 2012
PA-PSRS Patient Saf Advis. June 2012;9:50-57.
https://psnet.ahrq.gov/issue/patients-taking-their-own-medications-while-hospital
Discussing errors related to hospital patients' use of personal medications, this newsletter article provi…
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psnet.ahrq.gov/node/37106/psn-pdf
August 15, 2007 - Experts offer smart tips for smart pumps.
August 15, 2007
Gebhart F. Drug Topics. July 23, 2007.
https://psnet.ahrq.gov/issue/experts-offer-smart-tips-smart-pumps
This article describes how robust drug libraries developed for programmable smart pumps can help reduce
medication errors associated with traditional in…
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psnet.ahrq.gov/node/33976/psn-pdf
December 18, 2008 - Medical errors: overcoming the challenges.
December 18, 2008
Kalra J. Medical errors: overcoming the challenges. Clin Biochem. 2004;37(12):1063-71.
https://psnet.ahrq.gov/issue/medical-errors-overcoming-challenges
This commentary introduces several initiatives intended to help reduce medical error, such as developm…
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psnet.ahrq.gov/node/38683/psn-pdf
November 03, 2012 - Errors in Laboratory Medicine and Patient Safety.
November 3, 2012
Plebani M, ed. Clinica Chimica Acta. 2009;404(1):1-86.
https://psnet.ahrq.gov/issue/errors-laboratory-medicine-and-patient-safety
This collection of papers presented at an international conference on laboratory medicine focuses on
efforts to reduce…
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psnet.ahrq.gov/node/39744/psn-pdf
September 13, 2010 - Are you using checklists? Check!
September 13, 2010
McNellis B, AAPA QCC of the. Are you using checklists? Check!. JAAPA. 2010;23(7):24-6, 31.
https://psnet.ahrq.gov/issue/are-you-using-checklists-check
This piece emphasizes how checklists can be effective tools to prevent medical error and reduce
communication fa…
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psnet.ahrq.gov/node/35320/psn-pdf
September 14, 2005 - How business intelligence can improve patient safety.
September 14, 2005
Wanless S, McManaway J. Metaphor Analytics. August 30, 2005.
https://psnet.ahrq.gov/issue/how-business-intelligence-can-improve-patient-safety
This article illustrates how hospitals can use their own administrative and patient data to reduce h…
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.107_slideshow.ppt
November 01, 2005 - Spotlight Case [MONTH] 2003
Spotlight Case November 2005
Reconciling Doses
Source and Credits
This presentation is based on the November 2005 Spotlight Case in Emergency Medicine
See the full article at http://webmm.ahrq.gov
CME credit is available through the Web site
Commentary by: Frank Federico, RPh,…
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psnet.ahrq.gov/node/42940/psn-pdf
February 12, 2014 - Medical disrespect.
February 12, 2014
Yurkiewicz I. Aeon Magazine. January 29, 2014.
https://psnet.ahrq.gov/issue/medical-disrespect
Disruptive behavior is a well-known and pervasive issue in health care. Describing disrespectful behaviors
that clinicians face, such as sarcasm and intimidation, this magazine artic…
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psnet.ahrq.gov/node/38917/psn-pdf
September 06, 2013 - Health Care–Associated Infections.
September 6, 2013
Agency for Healthcare Research and Quality.
https://psnet.ahrq.gov/issue/health-care-associated-infections
For health care providers and consumers, this Web site features information, tools, and resources on
health care–associated infections (HAIs). AHRQ-funded …
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psnet.ahrq.gov/node/41919/psn-pdf
December 12, 2012 - The best medicine for fixing the modern hospital.
December 12, 2012
https://psnet.ahrq.gov/issue/best-medicine-fixing-modern-hospital
This news article highlights how hospital design can help reduce infection rates, shorten length of stay, and
improve patient safety.
https://psnet.ahrq.gov/issue/best-medicine-fixi…
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psnet.ahrq.gov/node/38971/psn-pdf
June 10, 2018 - How has the current economy affected patient safety?
June 10, 2018
ISMP Medication Safety Alert! Acute Care Edition. September 10, 2009;14:1-2.
https://psnet.ahrq.gov/issue/how-has-current-economy-affected-patient-safety
This piece describes how reduced resources could affect patient safety and quality work in hosp…
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psnet.ahrq.gov/node/39762/psn-pdf
October 01, 2010 - Dennis Quaid's quest.
August 18, 2010
Grant M. AARP The Magazine. September/October 2010;53:48-51,90-91.
https://psnet.ahrq.gov/issue/dennis-quaids-quest
This article highlights how a medication error inspired Dennis Quaid to promote patient safety and
chronicles his efforts to reduce harm in health care.
https:/…
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psnet.ahrq.gov/node/40481/psn-pdf
June 20, 2011 - Medication errors—new approaches to prevention.
June 20, 2011
Merry A, Anderson BJ. Medication errors--new approaches to prevention. Paediatr Anaesth.
2011;21(7):743-53. doi:10.1111/j.1460-9592.2011.03589.x.
https://psnet.ahrq.gov/issue/medication-errors-new-approaches-prevention
This review discusses evidence-bas…
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psnet.ahrq.gov/web-mm/hold-tpa
July 29, 2020 - Hold the tPA
Citation Text:
Fagan SC. Hold the tPA. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2005.
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