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psnet.ahrq.gov/node/49677/psn-pdf
February 01, 2013 - CVC Placement: Speak Now or Do Not Use the Line
February 1, 2013
Ault M, Rosen B. CVC Placement: Speak Now or Do Not Use the Line. PSNet [internet]. 2013.
https://psnet.ahrq.gov/web-mm/cvc-placement-speak-now-or-do-not-use-line
The Case
A 48-year-old woman with a history of hypertension, psychiatric illness, and a…
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psnet.ahrq.gov/node/49582/psn-pdf
April 01, 2009 - Breakage of a PICC Line
April 1, 2009
Dimov V. Breakage of a PICC Line. PSNet [internet]. 2009.
https://psnet.ahrq.gov/web-mm/breakage-picc-line
Case Objectives
Appreciate the incidence and consequences of PICC line breakage.
Understand the risk factors for PICC line breakage.
Understand the treatment options in…
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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.152_slideshow.ppt
June 01, 2007 - Spotlight Case [MONTH] 2003
Spotlight Case June 2007
Beeline to Spine
Source and Credits
This presentation is based on June 2007
AHRQ WebM&M Spotlight Case
See full article at http://webmm.ahrq.gov
CME credit is available online
Commentary by: Gerald W. Smetana, MD, Harvard Medical School, Beth Israel D…
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psnet.ahrq.gov/node/72618/psn-pdf
December 23, 2020 - Nudge Unit Supports Physician, Patient Behavioral
Changes Towards Medical Decisions that Improve Care
Value and Quality of Care
December 23, 2020
https://psnet.ahrq.gov/innovation/nudge-unit-supports-physician-patient-behavioral-changes-towards-
medical-decisions
Summary
Nudges are a change in the way choices ar…
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psnet.ahrq.gov/node/851971/psn-pdf
July 31, 2023 - Failure to Adhere to Dietary Restrictions Leading to
Complications and Poor Follow-up
July 31, 2023
Bohringer C, Bourgeois J, Xiong G, et al. Failure to adhere to dietary restrictions leading to complications
and poor follow-up. PSNet [internet]. 2023.
https://psnet.ahrq.gov/web-mm/failure-adhere-dietary-restricti…
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psnet.ahrq.gov/node/60242/psn-pdf
March 01, 2021 - 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/perspective/conversation-ashish-k-jha-md-mph
May 01, 2013 - research that all of us face is not becoming too wedded to any particular solution for improving quality, reducing … harm, or reducing health care costs.
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psnet.ahrq.gov/node/41175/psn-pdf
December 31, 2014 - Design and implementation of an automated email
notification system for results of tests pending at
discharge.
December 31, 2014
Dalal A, Schnipper JL, Poon EG, et al. Design and implementation of an automated email notification
system for results of tests pending at discharge. J Am Med Inform Assoc. 2012;19(4):52…
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psnet.ahrq.gov/node/43695/psn-pdf
August 02, 2015 - The medical liability climate and prospects for reform.
August 2, 2015
Mello MM, Studdert DM, Kachalia A. The medical liability climate and prospects for reform. JAMA.
2014;312(20):2146-55. doi:10.1001/jama.2014.10705.
https://psnet.ahrq.gov/issue/medical-liability-climate-and-prospects-reform
This review of natio…
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psnet.ahrq.gov/node/47835/psn-pdf
April 24, 2019 - Facilitation of surgical innovation: is it possible to speed
the introduction of new technology while simultaneously
improving patient safety?
April 24, 2019
Marcus RK, Lillemoe HA, Caudle AS, et al. Facilitation of Surgical Innovation: Is It Possible to Speed the
Introduction of New Technology While Simultaneousl…
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psnet.ahrq.gov/node/47333/psn-pdf
October 10, 2018 - Changing dynamics of the drug overdose epidemic in the
United States from 1979 through 2016.
October 10, 2018
Jalal H, Buchanich JM, Roberts MS, et al. Changing dynamics of the drug overdose epidemic in the United
States from 1979 through 2016. Science (1979). 2018;361(6408). doi:10.1126/science.aau1184.
https://p…
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psnet.ahrq.gov/node/44197/psn-pdf
November 03, 2015 - Effect of the World Health Organization checklist on
patient outcomes: a stepped wedge cluster randomized
controlled trial.
November 3, 2015
Haugen AS, Søfteland E, Almeland SK, et al. Effect of the World Health Organization checklist on patient
outcomes: a stepped wedge cluster randomized controlled trial. Ann Su…
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psnet.ahrq.gov/node/44471/psn-pdf
September 27, 2016 - Two sides of the safety coin?: how patient engagement
and safety climate jointly affect error occurrence in
hospital units.
September 27, 2016
Schiffinger M, Latzke M, Steyrer J. Two sides of the safety coin?: How patient engagement and safety
climate jointly affect error occurrence in hospital units. Health Care …
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psnet.ahrq.gov/node/44881/psn-pdf
August 16, 2017 - A comparative effectiveness analysis of the
implementation of surgical safety checklists in a tertiary
care hospital.
August 16, 2017
Bock M, Fanolla A, Segur-Cabanac I, et al. A Comparative Effectiveness Analysis of the Implementation of
Surgical Safety Checklists in a Tertiary Care Hospital. JAMA Surg. 2016;151(…
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psnet.ahrq.gov/node/45385/psn-pdf
January 03, 2017 - Viewing prevention of catheter-associated urinary tract
infection as a system: using systems engineering and
human factors engineering in a quality improvement
project in an academic medical center.
January 3, 2017
Rhee C, Phelps E, Meyer B, et al. Viewing Prevention of Catheter-Associated Urinary Tract Infection …
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psnet.ahrq.gov/node/40013/psn-pdf
July 24, 2011 - Patient participation in surgical site marking: can this be
an additional tool to help avoid wrong-site surgery?
July 24, 2011
Bergal LM, Schwarzkopf R, Walsh M, et al. Patient participation in surgical site marking: can this be an
additional tool to help avoid wrong-site surgery? J Patient Saf. 2010;6(4):221-5.
h…
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psnet.ahrq.gov/node/845361/psn-pdf
March 29, 2023 - A standardized marking procedure for ENT operations to
prevent wrong-site surgery: development, establishment
and subsequent evaluation among patients and medical
personnel.
March 29, 2023
Rohrmeier C, Abudan Al-Masry N, Keerl R, et al. A standardized marking procedure for ENT operations to
prevent wrong-site sur…
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psnet.ahrq.gov/node/40221/psn-pdf
July 21, 2011 - The association between a prolonged stay in the
emergency department and adverse events in older
patients admitted to hospital: a retrospective cohort
study.
July 21, 2011
Ackroyd-Stolarz S, Guernsey R, Mackinnon NJ, et al. The association between a prolonged stay in the
emergency department and adverse events in…
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psnet.ahrq.gov/node/46806/psn-pdf
January 01, 2020 - Examining the relationship of an all-cause harm patient
safety measure and critical performance measures at the
frontline of care.
February 28, 2018
Sammer C, Hauck L, Jones C, et al. Examining the Relationship of an All-Cause Harm Patient Safety
Measure and Critical Performance Measures at the Frontline of Care. …
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psnet.ahrq.gov/node/43323/psn-pdf
January 07, 2015 - Unrealized potential and residual consequences of
electronic prescribing on pharmacy workflow in the
outpatient pharmacy.
January 7, 2015
Nanji KC, Rothschild JM, Boehne JJ, et al. Unrealized potential and residual consequences of electronic
prescribing on pharmacy workflow in the outpatient pharmacy. J Am Med Inf…