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  1. Health Care Data Science for Quality Improvement and Patient Safety | PSNet

    psnet.ahrq.gov/perspective/health-care-data-science-quality-improvement-and-patient-safety
    October 01, 2016 - Health Care Data Science for Quality Improvement and Patient Safety Alvin Rajkomar, MD | October 1, 2016  Also Read a Conversation View more articles from the same authors. Citation Text: Rajkomar A. Health Care Data Science for Quality Improvement and Patient S…

  2. Count and Be Counted: Preparing Future Pharmacists to Promote a Culture of Safety | PSNet

    psnet.ahrq.gov/perspective/count-and-be-counted-preparing-future-pharmacists-promote-culture-safety
    April 01, 2006 - Count and Be Counted: Preparing Future Pharmacists to Promote a Culture of Safety Brian K. Alldredge, PharmD; Mary Anne Koda-Kimble, PharmD | April 1, 2006  Also Read a Conversation View more articles from the same authors. Citation Text: Alldredge BK, Koda-Kimb…

  3. Missed Compartment Syndrome after Steep Lithotomy Position for Laparoscopic Gynecological Surgery | PSNet

    psnet.ahrq.gov/web-mm/missed-compartment-syndrome-after-steep-lithotomy-position-laparoscopic-gynecological
    January 29, 2021 - Missed Compartment Syndrome after Steep Lithotomy Position for Laparoscopic Gynecological Surgery Citation Text: Bohringer C, Chavez G. Missed Compartment Syndrome after Steep Lithotomy Position for Laparoscopic Gynecological Surgery. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Qual…

  4. Delayed Symptomatic Subdural Hematoma Following an Initially Normal CT Head | PSNet

    psnet.ahrq.gov/web-mm/delayed-symptomatic-subdural-hematoma-following-initially-normal-ct-head
    March 27, 2024 - SPOTLIGHT CASE Delayed Symptomatic Subdural Hematoma Following an Initially Normal CT Head Citation Text: Martin R, Shahlaie K. Delayed Symptomatic Subdural Hematoma Following an Initially Normal CT Head. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department …

  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/866370/psn-pdf
    July 31, 2024 - Intraoperative Awareness during Rhinoplasty July 31, 2024 Bohringer C, Toor J. Intraoperative Awareness during Rhinoplasty. PSNet [internet]. 2024. https://psnet.ahrq.gov/web-mm/intraoperative-awareness-during-rhinoplasty Disclosure of Relevant Financial Relationships: As a provider accredited by the Accreditation …

  6. Falling-Through-Crack-Bedrails

    psnet.ahrq.gov/web-mm/falling-through-crack-bedrails
    February 19, 2020 - psnet

  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/74149/psn-pdf
    January 07, 2022 - Multiple Missed Opportunities for Suicide Risk Assessment in Emergency and Primary Care Settings January 7, 2022 Erb JL, Shah SB, Schiff G. Multiple Missed Opportunities for Suicide Risk Assessment in Emergency and Primary Care Settings. PSNet [internet]. 2022. https://psnet.ahrq.gov/web-mm/multiple-missed-opportu…

  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/853774/psn-pdf
    September 27, 2023 - Delayed Evaluation of Abdominal Pain in an Elderly Patient. September 27, 2023 Klimkiv L, Utter GH, Barnes DK. Delayed Evaluation of Abdominal Pain in an Elderly Patient. PSNet [internet]. 2023. https://psnet.ahrq.gov/web-mm/delayed-evaluation-abdominal-pain-elderly-patient The Case An 85-year-old woman presente…

  9. AHRQ PSNet Webinar (pdf file)

    psnet.ahrq.gov/sites/default/files/2025-03/PSNet%20Webinar%20Feb%202025_0.pdf
    January 01, 2025 - AHRQ PSNet Webinar AHRQ PSNet Webinar Making Healthcare Safer (MHS) IV: Rapid Response Systems and Opioid Stewardship February 10, 2025 Agenda 2 • Logistics • Introduction to the Making Healthcare Safer (MHS) IV Reports • Report 1 – Rapid Response Systems ► Discussion ► PSNet Resources • Report 2 – Opioi…

  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/853902/psn-pdf
    September 27, 2023 - A Missed Bowel Perforation - the Importance of Diagnostic Reasoning September 27, 2023 Timbag L, Sinigayan VR, Molla M. A Missed Bowel Perforation - the Importance of Diagnostic Reasoning. PSNet [internet]. 2023. https://psnet.ahrq.gov/web-mm/missed-bowel-perforation-importance-diagnostic-reasoning Disclosure of …

  11. Fatal Patient-Controlled Analgesia (PCA) Opioid-Induced Respiratory Depression | PSNet

    psnet.ahrq.gov/web-mm/fatal-patient-controlled-analgesia-pca-opioid-induced-respiratory-depression
    May 26, 2021 - SPOTLIGHT CASE Fatal Patient-Controlled Analgesia (PCA) Opioid-Induced Respiratory Depression Citation Text: Fazio S, Firestone R. Fatal Patient-Controlled Analgesia (PCA) Opioid-Induced Respiratory Depression. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Depar…

  12. Delayed Evaluation of Abdominal Pain in an Elderly Patient. | PSNet

    psnet.ahrq.gov/web-mm/delayed-evaluation-abdominal-pain-elderly-patient
    February 26, 2020 - Delayed Evaluation of Abdominal Pain in an Elderly Patient. Citation Text: Klimkiv L, Utter GH, Barnes DK. Delayed Evaluation of Abdominal Pain in an Elderly Patient.. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2023. Copy Citat…

  13. Failure to Adhere to Dietary Restrictions Leading to Complications and Poor Follow-up | PSNet

    psnet.ahrq.gov/web-mm/failure-adhere-dietary-restrictions-leading-complications-and-poor-follow
    September 27, 2023 - Failure to Adhere to Dietary Restrictions Leading to Complications and Poor Follow-up Citation Text: Bohringer C, Bourgeois J, Xiong G, et al. Failure to adhere to dietary restrictions leading to complications and poor follow-up.. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality,…

  14. A Stroke of Error | PSNet

    psnet.ahrq.gov/web-mm/stroke-error
    February 01, 2016 - SPOTLIGHT CASE A Stroke of Error Citation Text: Barrett KM. A Stroke of Error. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2014. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML End…

  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/838220/psn-pdf
    September 27, 2019 - Primary Care and Patient Safety: Opportunities at the Interface September 28, 2022 O’Malley P, McNellis B, Chew E, et al. Primary Care and Patient Safety: Opportunities at the Interface. PSNet [internet]. 2022. https://psnet.ahrq.gov/perspective/primary-care-and-patient-safety-opportunities-interface Editor’s Not…

  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/60363/psn-pdf
    March 01, 2021 - Transition Coaches® Reduce Readmissions for Medicare Patients With Complex Postdischarge Needs Originally published on June 12, 2020 Last updated on January 11, 2021 https://psnet.ahrq.gov/innovation/transition-coachesr-reduce-readmissions-medicare-patients-complex- postdischarge-needs Summary Under a program kn…

  17. Multiple Missed Opportunities for Suicide Risk Assessment in Emergency and Primary Care Settings | PSNet

    psnet.ahrq.gov/web-mm/multiple-missed-opportunities-suicide-risk-assessment-emergency-and-primary-care-settings
    May 26, 2021 - Multiple Missed Opportunities for Suicide Risk Assessment in Emergency and Primary Care Settings Citation Text: Erb JL, Shah SB, Schiff G. Multiple Missed Opportunities for Suicide Risk Assessment in Emergency and Primary Care Settings. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Qu…

  18. In Conversation with…Donald M. Berwick, MD, MPP | PSNet

    psnet.ahrq.gov/perspective/conversation-withdonald-m-berwick-md-mpp
    November 01, 2005 - In Conversation with…Donald M. Berwick, MD, MPP November 1, 2005  Also Read an Essay Citation Text: In Conversation with…Donald M. Berwick, MD, MPP. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Ser…

  19. Intraoperative Awareness during Rhinoplasty | PSNet

    psnet.ahrq.gov/web-mm/intraoperative-awareness-during-rhinoplasty
    January 29, 2021 - SPOTLIGHT CASE Intraoperative Awareness during Rhinoplasty Citation Text: Bohringer C, Toor J. Intraoperative Awareness during Rhinoplasty. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2024. Copy Citation Format: …

  20. Preparing for Health Reform: The Federal Government and the Nursing Workforce | PSNet

    psnet.ahrq.gov/perspective/preparing-health-reform-federal-government-and-nursing-workforce
    September 01, 2012 - Preparing for Health Reform: The Federal Government and the Nursing Workforce Peter I. Buerhaus, PhD, RN | September 1, 2012  Also Read a Conversation View more articles from the same authors. Citation Text: Buerhaus P. Preparing for Health Reform: The Federal G…
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