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1. Preventing Medication Errors in Ambulatory Care: The Importance of Establishing Regimen Concordance (pdf file)
   preventiveservices.ahrq.gov/downloads/pub/advances/vol1/Schillinger.pdf
   January 01, 2004 - Results: One hundred fifty-five patients (70.5 percent) reported no missed warfarin doses during the … perfect 30-day adherence, with those who reported non-adherence. … perfect 30-day adherence, with those who reported non-adherence. … Among those patients who reported perfect 30-day adherence, a comparison of patients who reported a … Comparing patients who reported a regimen greater in strength than that reported by the clinician (n

2. Network of Patient Safety Databases Chartbook, 2023 (pdf file)
   preventiveservices.ahrq.gov/sites/default/files/wysiwyg/npsd/data/npsd-chartbook-2023.pdf
   January 01, 2023 - reported?” … Following the previous example, DE3: “What is being reported?” … , No harm was reported most frequently (47.0%; 781,254 / 1,661,223). … Out of 1,661,223 reported Incidents, 4.5% (74,714) did not have any data on EXTENT OF HARM reported. … Out of 1,661,223 reported Incidents, 4.5% (74,714) did not have any data on EXTENT OF HARM reported.

3. Network of Patient Safety Databases Chartbook, 2019 (pdf file)
   preventiveservices.ahrq.gov/sites/default/files/wysiwyg/npsd/data/npsd-chartbook-2019.pdf
   January 01, 2019 - Five EVENT TYPES can be reported as Incidents or Near misses. … Mild harm were reported most frequently. … Among Incidents where the EXTENT OF HARM was reported, the most commonly reported category of EXTENT … This figure includes Incidents where the EXTENT OF HARM was reported. … 3,908 / 14,923) of the INCORRECT ACTIONS reported.

4. Network of Patient Safety Databases Falls Chartbook, 2023 (pdf file)
   preventiveservices.ahrq.gov/sites/default/files/wysiwyg/npsd/data/npsd-falls-chartbook-2023.pdf
   January 01, 2023 - Patients under 18 made up only 3.1% (7,564 / 243,449) of reported falls. … PATIENT AGE was unknown for 4.1% of reported falls (9,971 / 243,449). … While patients Under 18 made up only 3.1% of all reported falls (see above, Falls by Age) they had … the highest rates of Injury reported (12.7; 957 / 7,564). … Among patients Under 18, no risk factor was the most commonly reported (54.1%; 211 / 390).

5. Final Progress Report: ESDP in Community Hospitals (pdf file)
   preventiveservices.ahrq.gov/sites/default/files/2024-01/holland-report.pdf
   January 01, 2024 - Patients with high ESDP scores reported more problems after discharge (p = 0.02), reported a lower quality … Compare self-reported quality of life between patients in a regional community hospital with high ESDP … Because problems and unmet needs are self-reported, patients with dementia identified in the medical … Problems and unmet needs are reported both as ‘any at all’ and as the average number reported (overall … Self-reported quality of life (see Table 3).

6. Comparative Reports on Physicians | Agency for Healthcare Research and Quality
   preventiveservices.ahrq.gov/talkingquality/resources/comparative-reports/physicians.html
   October 01, 2022 - Performance scores are reported on the website for preventive care, care for chronic conditions such … Patient experience scores are also reported for some physician groups and ACOs. … Performance scores are reported on the website using symbols and numeric data. … Clinical quality measures are reported for asthma care, cancer screening, diabetes care, mental health … Performance scores are reported on the website using word icons.

7. Hospital Survey on Patient Safety Culture Version 2.0: Composites and Items (pdf file)
   preventiveservices.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/hospital/hospitalsurvey2-items.pdf
   August 01, 2019 - When an event is reported in this unit, it feels like the person is being written up, not the problem … When a mistake is caught and corrected before reaching the patient, how often is this reported? … When a mistake reaches the patient and could have harmed the patient, but did not, how often is this reported … Reliability of this composite measure—Cronbach’s alpha (3 items) = .72 Number of Events Reported … In the past 12 months, how many patient safety events have you reported?

8. Dashboard Information | Agency for Healthcare Research and Quality
   preventiveservices.ahrq.gov/npsd/data/dashboard/info.html
   June 01, 2019 - There are 10 CFER-H modules: one Generic module applies to all reported events, and nine event-specific … Data Elements refer to the concepts reported in the CFER-H and captured through individual questions … asked of reporters for each patient safety concern (e.g., “What is being reported?” … Following the previous example, the Data Element “What is being reported?”

9. Patient Experience as a Source for Understanding the Origins, Impact, and Remediation of Diagnostic Errors, Volume 2: Eliciting Patient Narratives (pdf file)
   preventiveservices.ahrq.gov/sites/default/files/wysiwyg/topics/dxsafety-patient-experience-vol2.pdf
   July 01, 2023 - Observations will not necessarily be reported on surveys or other mechanisms for collecting experiential … Which Aspects of Diagnosis-Related Experiences Should Be Elicited and Reported? … Illustrations of persisting sequelae of diagnostic mishaps reported in elicited patient narratives … But only 14 percent more reported such an event from 2 to 5 years before the survey (less than half … Using patient reported information to improve clinical practice.

10. Slide 1
    preventiveservices.ahrq.gov/sites/default/files/wysiwyg/cpi/about/mission/arra/arracer-slides.pptx
    October 15, 2013 - of AHRQ and its EHC Program 22 22 Consumer Survey Findings (Wave 1 ) 18% of surveyed consumers reported … under 1% had used its products 23 23 Consumer Survey Findings (Wave 2) 21% of surveyed consumers reported … to 65%, 18% to 21% respectively), although the increase was not statistically significant Consumers reported … statistically significant increase in awareness of AHRQ from wave 1 to wave 2 (4% to 11%) Consumers reported … significant increase in interest in learning about the EHC Program over time (44% to 58%) Consumers reported

11. Findings From the AHRQ Transforming Primary Care Grant Initiative: A Synthesis Report (pdf file)
    preventiveservices.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/primary-care/tpc/tpc-synthesis-report.pdf
    July 22, 2015 - However, a number of other motivations were reported, including a desire to be involved in cutting-edge … A conventional content analysis approach was used to identify themes across grants as reported. 2 … Only one of the 14 studies reported that practices implemented changes to fewer than four of the five … • Thirteen of the grants reported that practices engaged in practice changes related to providing … In addition, a number of financial incentives were reported as motivating transformation initiatives

12. Best Practices for Administering SOPS® Surveys Users (Webcast): Sorra Presentation (pdf file)
    preventiveservices.ahrq.gov/sites/default/files/wysiwyg/sops/events/webinar/best-practices-survey-administration-webcast-sorra.pdf
    January 01, 2024 - Respondent Demographics Composite Measure Results Item Results Patient Safety Rating Number of Events Reported … Comparative Results Composite Measures Results Item Results Patient Safety Rating Number of Events Reported … Staff Position Composite Measure Results Item Results Patient Safety Rating & Number of Events Reported … Unit/Work Area Composite Measure Results Item Results Patient Safety Rating & Number of Events Reported … Unit/Work Area Composite Measure Results Item Results Patient Safety Rating & Number of Events Reported

13. Understanding the Transformation Experiences of Small Practices With NCQA Medical Home Recognition (pdf file)
    preventiveservices.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/primary-care/tpc/tpc-profile-scholle.pdf
    April 01, 2015 - Approximately 85 percent of practices reported receiving some form of physician and staff training. … Key Impacts of Transformation Quality of Care • In the case studies, physicians reported that they … Staff reported that having the authority to make decisions empowered them to be more involved in … Physicians and staff reported that these were instrumental to PCMH transformation.

14. TeamSTEPPS Mutual Support Facilitator Participant Worksheet (pdf file)
    preventiveservices.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/video/module-4-mutual-support-participant-worksheet.pdf
    February 14, 2024 - 30 minutes Individual reflections Small group discussions Small group sharing - Key takeaways reported … Prepare key takeaways - to be reported out by a member of each small group ~8 minutes ▪ What are

15. Diagnostic Safety Grants Awarded in FY 2019 | Agency for Healthcare Research and Quality
    preventiveservices.ahrq.gov/diagnostic-safety/research/grants-2019.html
    March 01, 2024 - patient-centered framework co-designed with patients/families and care partners to measure and categorize patient-reported … apply this new analytic tool to establish the incidence, types, and contributing factors to patient-reported … use and impact of this method on the diagnostic process measuring safety (incidence/types of patient-reported

16. Draft Final Report Estimating the Additional Hospital Inpatient Cost and Mortality Associated with Selected Hospital Acquired Conditions (pdf file)
    preventiveservices.ahrq.gov/sites/default/files/publications2/files/hac-cost-report2017.pdf
    November 01, 2017 - When the RR was not reported or could not be calculated, we used the OR value to approximate RR, based … Excess mortality is reported as the number of deaths per case of HAC. … For example, we excluded studies that only reported attributable cost and significance level because … There was significant variability in reported mortality between studies, due mainly to variation in … Not reported Not reported Not reported 3.4 (1.2, 12.3) 3.07 (1.36 – 6.90) SE(logRR)/SE(logOR) 0.414

17. Register Now: April 25 Webinar Will Launch HHS Series on National Action Alliance To Advance Patient Safety | Agency for Healthcare Research and Quality
    preventiveservices.ahrq.gov/news/newsletters/e-newsletter/858.html
    April 01, 2023 - Nurse Staffing Gaps Reported in Hospitals With More Vulnerable Maternity Patients, Study Finds . … Nurse Staffing Gaps Reported in Hospitals With More Vulnerable Maternity Patients, Study Finds Most … hospitals adhere to nurse staffing guidelines, but gaps in staffing are reported more frequently at … They found that nurses reported strong adherence to staffing guidelines in their hospitals; but higher … They concluded that gaps in staffing were reported more frequently at hospitals serving the most vulnerable

18. How Does the NPSD Work? | Agency for Healthcare Research and Quality
    preventiveservices.ahrq.gov/npsd/how-does-npsd-work/index.html
    February 01, 2024 - Only data for CFER-H have been reported to the PSOPPC/NPSD; therefore, they are the only source of data … NPSD Data Are Unique The data presented by the NPSD differ from clinical quality measures reported … Clinical quality measures reported by other agencies typically focus on all eligible members of the population

19. Step Up App Challenge: Advancing Care Through Patient Assessments | Agency for Healthcare Research and Quality
    preventiveservices.ahrq.gov/challenges/past/step-up-app/index.html
    January 01, 2022 - About the Challenge Patient-reported outcomes (PROs) are defined as "any report of the status of a … AHRQ provided a copy of the Patient-Reported Outcomes Measurement Information System (PROMIS®) physical … approach, benchmarked pain and function scores from the National Institutes of Health (NIH) Patient-Reported … to provide sought-after data through "Campaigns" (e.g., Chronic Disease Management Campaign, Patient-Reported … activity, cliexa®'s Platform for Chronic Care Management enables clinicians to fully leverage patient-reported

20. Transitioning to the SOPS™ Hospital Survey Version 2.0: What’s Different and What To Expect, Part II: Appendixes (pdf file)
    preventiveservices.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/hospital/hsops2-pt2_transition_apx.pdf
    September 01, 2019 - (D2) When a mistake is made that could harm the patient, but does not, how often is this reported? … (A8R) 57% 50% 7% Added “In this unit” When an event is reported in this unit, it feels like the … (A7R) When an event is reported, it feels like the person is being written up, not the problem. … have you reported? … events have you reported?