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  1. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol3/Furmaga.pdf
    January 01, 2005 - Reducing the Use of Short-acting Nifedipine by Hypertensives Using a Pharmaceutical Database 277 Reducing the Use of Short-acting Nifedipine by Hypertensives Using a Pharmaceutical Database Elaine M. Furmaga, Peter A. Glassman, Francesca E. Cunningham, Chester B. Good Abstract Objective: In view of the wi…
  2. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol3/Graham.pdf
    April 14, 2004 - Institutional Review Board Approval of Practice-based Research Network Patient Safety Studies 453 Institutional Review Board Approval of Practice-based Research Network Patient Safety Studies Deborah G. Graham, Wilson Pace, Jennifer Kappus, Sherry Holcomb, James M. Galliher, Christine W. Duclos, Aaron J. B…
  3. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol2/Advances-Stalhandske2_70.pdf
    March 01, 2006 - VHA’s National Falls Collaborative and Prevention Programs VHA’s National Falls Collaborative and Prevention Programs Erik Stalhandske, MPP, MHSA; Peter Mills, PhD; Pat Quigley, PhD, ARNP, CRRN, FAAN; Julia Neily, MS, MPH; James P. Bagian, MD, PE Abstract Falls are a high-volume, high-cost problem in he…
  4. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Whitten_85.pdf
    June 05, 2008 - News Media and Health Care Providers at the Crossroads of Medical Adverse Events News Media and Health Care Providers at the Crossroads of Medical Adverse Events Pamela Whitten, PhD; Mohan J. Dutta, PhD; Serena Carpenter, PhD; Graham D. Bodie Abstract In 2005, Indiana Governor Mitch Daniels issued an executi…
  5. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol4/Kizer2.pdf
    December 01, 2000 - Serious Reportable Adverse Events in Health Care 339 Serious Reportable Adverse Events in Health Care Kenneth W. Kizer, Melissa B. Stegun Abstract Health care errors resulting in patient harm are a leading cause of morbidity and mortality in the United States, although there is no national reporting of such…
  6. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol2/Advances-Baker_107.pdf
    March 30, 2008 - Analysis of Patient Safety: Converting Complex Pediatric Chemotherapy Ordering Processes from Paper to Electronic Systems Analysis of Patient Safety: Converting Complex Pediatric Chemotherapy Ordering Processes from Paper to Electronic Systems Donald K. Baker, PharmD; James M. Hoffman, PharmD; Gregory A. Hal…
  7. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol3/Advances-Nemeth_116.pdf
    April 27, 2008 - Minding the Gaps: Creating Resilience in Health Care Minding the Gaps: Creating Resilience in Health Care Christopher Nemeth, PhD; Robert Wears, MD; David Woods, PhD; Erik Hollnagel, PhD; Richard Cook, MD Abstract Resilience is the intrinsic ability of a system to adjust its functioning prior to, during, or …
  8. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol3/Advances-Drews_15.pdf
    February 26, 2008 - Error Producing Conditions in the Intensive Care Unit Error Producing Conditions in the Intensive Care Unit Frank A. Drews, PhD; Adrian Musters, BS; Matthew H. Samore, MD Abstract Up to 98,000 patients die because of human error in U.S. hospitals each year. Among the areas where errors occur frequently is t…
  9. www.ahrq.gov/sites/default/files/publications/files/obesity-pcpresources.pdf
    May 01, 2014 - Integrating Primary Care Practices and Community-based Resources to Manage Obesity Integrating Primary Care Practices and Community-based Resources to Manage Obesity A Bridge-building Toolkit for Rural Primary Care Practices Prepared for Agency for Healthcare Research and Quality 540 Gaither Road Rockv…
  10. www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/primary-care/tpc/estimating-costs-primary-care-transformation.pdf
    July 31, 2015 - obtained from a variety of sources, including: • Qualitative and mixed data collected from clinic representatives
  11. www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/long-term-care/resources/ontime/prevhosp/prevehosp-reports-ig.pdf
    November 30, 2013 - AHRQ’s Safety Program for Nursing Homes: On-Time Preventable Hospital and ED Visits 1 On-Time Preventable Hospital and ED Visits: Reports AHRQ’s Safety Program for Nursing Homes: On-Time Preventable Hospital and ED Visits Training Slide 1: Introduction to Preventable Hospital and ED Visits Reports …
  12. www.ahrq.gov/research/findings/nhqrdr/chartbooks/carecoordination/carecoordination-slides.html
    June 01, 2018 - Chartbook on Care Coordination: Slide Presentation National Healthcare Quality and Disparities Report Slide 1 National Healthcare Quality and Disparities Report Chartbook on Care Coordination June 2016 Slide 2 National Healthcare Quality and Disparities Report Annual report to Congress mandat…
  13. www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/highlights/ps-project-highlights-teamwork-leadership.pdf
    April 30, 2025 - AHRQ-Funded Patient Safety Project Highlights: Improving Healthcare Safety by Enhancing Teamwork and Leadership AHRQ-Funded Patient Safety Project Highlights Improving Healthcare Safety by Enhancing Teamwork and Leadership Overview According to the Joint Commission, in 2022, failures in communication, teamwork, a…
  14. www.ahrq.gov/sites/default/files/wysiwyg/research/findings/final-reports/environmental-scan-programs/envptscan.pdf
    June 01, 2013 - Environmental Scan of Patient Safety Education and Training Programs Contract Final Report Environmental Scan of Patient Safety Education and Training Programs Prepared for: Agency for Healthcare Research and Quality U.S. Department of Health and Human Services 540 Gaither Road Rockville, M…
  15. www.ahrq.gov/sites/default/files/2024-05/anderson-thomas-report.pdf
    January 01, 2024 - Final Progress Report: Simulation to Support Competency-Based Training in Orthopedic Trauma 1. TITLE PAGE Title of Project: Simulation to Support Competency-Based Training in Orthopedic Trauma Principal Investigator and Team Members. Principal Investigators: Donald D. Anderson, PhD – Professor, Orthopedics & Rehab…
  16. www.ahrq.gov/sites/default/files/2025-03/fenton-report.pdf
    January 01, 2025 - Final Progress Report: Watchful Waiting as a Strategy for Reducing Low-value Spinal Imaging Agency for Healthcare Quality and Research Research Grant Final Report December 5, 2024 Watchful Waiting as a Strategy for Reducing Low-valu…
  17. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol4/Advances-Devine_83.pdf
    April 06, 2008 - Implementing an Ambulatory e-Prescribing System: Strategies Employed and Lessons Learned to Minimize Unintended Consequences Implementing an Ambulatory e-Prescribing System: Strategies Employed and Lessons Learned to Minimize Unintended Consequences Emily B. Devine, PharmD, MBA; Jennifer L. Wilson-Norton, RPh, MBA…
  18. www.ahrq.gov/sites/default/files/2024-01/thamer-report.pdf
    January 01, 2024 - Final Progress Report: Do Safety Warnings Change Prescribing Among the US Dialysis Population? Principal Investigator: Thamer, Mae FINAL REPORT TITLE PAGE Title: Do Safety Warnings Change Prescribing among the US Dialysis Population? Principal Investigator and Team Members: M Thamer, PI, and other team members (…
  19. www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa/049-dec-implementation-slides.pptx
    October 01, 2024 - AHRQ Safety Program for MRSA Prevention AHRQ Safety Program for MRSA Prevention Implementation of Chlorhexidine Gluconate (CHG) Bathing and Nasal Decolonization ICU & Non-ICU AHRQ Pub. No. 25-0007 October 2024 AHRQ Safety Program for MRSA Prevention | ICU & Non-ICU AHRQ Safety Program for MRSA Prevention | ICU & No…
  20. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/candor/module6/mod6-care-for-caregiver-guide.pdf
    April 01, 2016 - Purpose: To guide an organization in developing and implementing a Care for the Caregiver program. Who should use this tool? The Care for the Caregiver Program Lead How to use this tool: Use this guide as a checklist to ensure the needed elements for implementation of a Care for the Caregiver program. There are six …

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