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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Kaprielian_9.pdf
January 01, 2007 - incorrect
“ Administration
1. errors in handling/transmission of messages
2. errors in appointment
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digital.ahrq.gov/sites/default/files/docs/citation/r21hs024327-ornstein-final-report-2018.pdf
January 01, 2018 - “We were down for 4 hours and lost all d ata captured during that time, including appointments … For six months, patients were showing up for appointments that we did not know
had been
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cds.ahrq.gov/sites/default/files/cds/artifact/476/2024_CDS_Connect_IG_Pain_Management_Summary.pdf
January 01, 2024 - Suggested Action: Determine next followup appointment.
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www.ahrq.gov/sites/default/files/wysiwyg/cahps/news-and-events/events/20140115_DB/Final_Using_the_CAHPS_Database_Webcast_Transcript.pdf
January 01, 2014 - at that point for questions and answers, and then
wrap up with a few comments on the CAHPS Database schedule … displays the percent of survey respondents who chose the most positive
score for the “getting timely appointments … overall along with the lowest
score, the highest score, and the average score for the “getting timely appointments … It provides information on access by using
questions such as, how easy was it to get appointments and … That is, how easy it was to get hold of a practice, how easy it
was to get an appointment, and how well
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www.ahrq.gov/sites/default/files/2024-07/ashton-report.pdf
January 01, 2024 - This act, signed into law in October 2000, includes provisions that allow
physicians to dispense Schedule
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psnet.ahrq.gov/web-mm/dropping-new-lows
December 18, 2024 - SPOTLIGHT CASE
Dropping to New Lows
Citation Text:
Juang PC, Kulasa K. Dropping to New Lows. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2016.
Copy Citation
Format:
Google Scholar BibTeX EndNote X3 XML End…
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digital.ahrq.gov/sites/default/files/docs/citation/r01hs015188-huck-final-report-2008.pdf
January 01, 2008 - Rural Healthcare Quality Network (RHQN) - Final Report
Grant Final Report
Grant ID: R01 HS 015188
Rural Healthcare Quality Network (RHQN)
Inclusive dates: 09/17/04 - 08/31/08
Principal Investigator:
Jacqueline Huck
Performing …
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digital.ahrq.gov/sites/default/files/docs/publication/p20hs015295-size-final-report-2005.pdf
January 01, 2005 - Developing Shared EHR Infrastructure in Wisconsin
Grant Final Report
Grant ID: 1P20HS015295
Developing Shared EHR Infrastructure in Wisconsin
Inclusive Project Dates: 10/01/14 – 10/01/15
Principal Investigator:
Tim Size
Team Members:
Larry Clifford
Kendra Jacobs
Carla Alvarado
Bruce…
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digital.ahrq.gov/sites/default/files/docs/citation/r21hs023994-tubb-final-report-2018.pdf
January 01, 2018 - A Mobile App to Enhance Smoking Cessation Shared Decision Making in Primary Care - Final Report
Title of Project: A Mobile App to Enhance Smoking Cessation Shared Decision Making
in Primary Care
Principal Investigator: Matthew Tubb MD PhD
Team Members: Nancy Elder MD MSPH, Saundra Regan PhD, Sha…
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digital.ahrq.gov/sites/default/files/docs/publication/r21hs022166-beebe-final-report-2016.pdf
January 01, 2016 - The Long Term Effectiveness of Telephone Intervention Problem Solving (TIPS) - Final Report
The long term effectiveness of Telephone Intervention Problem Solving (TIPS).
PI Lora Humphrey Beebe, PhD, PMHNP-BC
Team members:
Kathleen D Smith, PhD, interventionist;
Abbas Tavakoli, PhD…
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www.ahrq.gov/sites/default/files/2024-07/wears-report.pdf
January 01, 2024 - Final Progress Report: Reducing Risks by Engineering Resilience Into HIT for EDs
Reducing Risks by Engineering Resilience into HIT for EDs
Principal Investigator: Robert L. Wears, MD, MS, PhD
Team Members:
John Wreathall
Rollin (Terry) Fairbanks, MD, MS
Ann M. Bisantz, PhD
Shawna J Perry, MD
Chris Johnson,…
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psnet.ahrq.gov/node/849679/psn-pdf
June 28, 2023 - Under Pressure: Tracheostomy Cuff Over Inflation
Leading to Tissue Necrosis and Cuff Rupture
June 28, 2023
Gould E, Carlsen K, Trask J, et al. Under Pressure: Tracheostomy Cuff Over Inflation Leading to Tissue
Necrosis and Cuff Rupture. PSNet [internet]. 2023.
https://psnet.ahrq.gov/web-mm/under-pressure-tracheost…
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/icu-assessment.docx
April 01, 2022 - ICU Assessment
AHRQ Safety Program for Intensive Care Units: Preventing CLABSI and CAUTI
Date Completed by Team: _____________________
ICU Assessment of Current CLABSI & CAUTI Prevention Practices
The purpose of this assessment is to understand current central line-associated bloodstream infections (CLABSI) and…
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www.ahrq.gov/policymakers/chipra/demoeval/what-we-learned/highlight10.html
August 01, 2014 - How are CHIPRA quality demonstration States testing the Children's Electronic Health Record Format?
Evaluation Highlight No. 10
Author: Leslie Foster
Contents
Key Messages
Background
Findings
Conclusion
Implications
Learn More
Endnotes
The CHIPRA Quality Demonstration Grant Program…
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www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/demoeval/what-we-learned/highlight10.pdf
September 08, 2015 - Evaluation Highlight No.10, August 2014
The CHIPRA Quality
Demonstration Grant Program
In February 2010, the Centers for Medicare &
Medicaid Services (CMS) awarded 10 grants,
funding 18 States, to improve the quality of
health care for children enrolled in Medicaid
and the Children’s Health Insurance Program
…
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psnet.ahrq.gov/node/861760/psn-pdf
January 31, 2024 - Syringe Swap During Regional Block: A Case of
Medication Error and Recovery
January 31, 2024
Beres K, Gutierrez MC. Syringe Swap During Regional Block: A Case of Medication Error and Recovery.
PSNet [internet]. 2024.
https://psnet.ahrq.gov/web-mm/syringe-swap-during-regional-block-case-medication-error-and-recover…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/implement/implement-facilitator-guide.docx
May 01, 2017 - AHRQ Safety Program for Perinatal Care
Implement Teamwork and Communication for Perinatal Safety
Implement Teamwork and Communication for Perinatal Safety
SAY:
The Implement Teamwork and Communication module of the AHRQ Safety Program for Perinatal Care will help you understand the importance of effective communicatio…
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www.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/teamwork/implement-fac-guide.html
July 01, 2023 - Implement Teamwork and Communication for Perinatal Safety: Facilitator Guide
AHRQ Safety Program for Perinatal Care
Slide 1: Implement Teamwork and Communication for Perinatal Safety
Say:
The Implement Teamwork and Communication module of the AHRQ Safety Program for Perinatal Care will help you understa…
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psnet.ahrq.gov/node/33863/psn-pdf
August 01, 2018 - In Conversation With… Matthew Weinger, MD
August 1, 2018
In Conversation With… Matthew Weinger, MD. PSNet [internet]. 2018.
https://psnet.ahrq.gov/perspective/conversation-matthew-weinger-md
Editor's note: Dr. Weinger is Director of the Center for Research and Innovation in Systems Safety and
Professor of Anesthes…
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www.ahrq.gov/sites/default/files/wysiwyg/takeheart/training/module-5-implementation-guide.pdf
June 02, 2025 - TAKEheart Automatic Referral Implementation Guide - Module 5
Module 5 Implementation Guide:
Building and Implementing a Successful Automatic Cardiac Rehab Referral System
Purpose and Overview
This implementation guide is designed to help you think through the steps you will need to address in
designing and i…