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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/sustaining-change-transcript.docx
April 14, 2015 - April 14, 2015
Sustaining Change
Speaker 1: The following is a recording for [Cathy Drury 00:00:02], with the American Hospital Association in Chicago, for the April National conference 00:00:06 call on Tuesday, April 14, 2015 at 11 a.m. central time. Excuse me everyone. We now have all of our speakers in conference. P…
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www.ahrq.gov/research/findings/nhqrdr/chartbooks/access/access-slides.html
June 01, 2018 - Access to Health Care Chartbook: Slide Presentation
National Healthcare Quality and Disparities Report
Slide 1
National Healthcare Quality and Disparitites Report
Chartbook on Access to Health Care
May 2016
Slide 2
National Healthcare Quality and Disparities Report
Annual report to Congress m…
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www.ahrq.gov/sites/default/files/2024-07/congdon-magilvy-report.pdf
January 01, 2024 - Final Progress Report: Quality Factors in Nursing Home Choice
1
Title Page
Title of Project: Quality Factors in Nursing Home Choice
Principal Investigator: JoAnn G. Congdon
Team Members:
Co-Principal Investigator: Joan K. Magilvy
Investigator: Mary A. Blegen
Investigator: Katherine R. Jones
Investigator: Nor…
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www.ahrq.gov/sites/default/files/2024-01/gurwitz-report.pdf
January 01, 2024 - Final Progress Report: Enhancing the Safety of Warfarin in the Nursing Home
Project Title: Enhancing the Safety of Warfarin in the Nursing Home
Principal Investigator: Jerry H. Gurwitz, MD
Principal Team Members: Jerry Gurwitz, MD; Terry S. Field, DSc; Jennifer Tjia, MD,
MSCE; Kathleen M. Mazor, EdD; Leslie R. Ha…
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www.ahrq.gov/sites/default/files/2024-02/zierler-report.pdf
January 01, 2024 - Final Progress Report: VTE Safety Toolkit: A Systems Approach to Patient Safety
Title: VTE Safety Toolkit: A Systems Approach to Patient Safety
Principal Investigator: Brenda K. Zierler, PhD1
Team Members:
Ann Wittkowsky, PharmD2
Robb Glenny, MD3
Seth Wolpin, PhD1
Jung-Ah Lee, MN1
Gene Peterson, MD, PhD3
Fre…
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www.ahrq.gov/sites/default/files/2024-01/muller-report.pdf
January 01, 2024 - Final Progress Report: Medication Reconciliation: Bridging Communications Across the Continuum of Care
Title: Medication Reconciliation: Bridging Communications Across the Continuum of
Care
Principal Investigator and Team Members: Melinda Muller, MD, Lynn Belcher, RPh,
Melissa Blanchard, MP, Amy Caster-Winegeart, …
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www.ahrq.gov/sites/default/files/wysiwyg/action-alliance/addressing-workforce-safety-062723.pdf
July 25, 2023 - The National Action Alliance to Advance Patient Safety Summer Webinar Series: CDC Presentation
The National Action Alliance to Advance Patient Safety
Summer Webinar Series
Addressing Violence in the Workplace
June 27, 2023
2:00-3:00 PM ET
Special Guest Speakers
2
Martin Hatlie, JD
President & CEO,
Project P…
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www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/chipra-131-section-5-table-8-9.pdf
January 01, 2013 - Section 5, Tables 8 and 9
…
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www.ahrq.gov/sites/default/files/2024-04/ratliff-report.pdf
January 01, 2024 - Final Progress Report: Developing a patient-centered model of the risk of perioperative complications in spine surgery
Developing a patient-centered model of the risk of perioperative complications in spine surgery
John Ratliff, MD, PI
Team members:
Summer Han, PhD
Richard Olshen, PhD
Lu Tian, PhD
Paola Suarez
…
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www.ahrq.gov/sites/default/files/wysiwyg/cahps/cahps-database/about/2014cahpshealthplanchartbook.pdf
October 01, 2014 - 2014 CAHPS Health Plan Survey Database Chartbook
THE CAHPS DATABASE
2014 CAHPS Health Plan
Survey Database
2014 Chartbook: What Consumers Say About Their
Experiences with Their Health Plans and Medical Care
AHRQ Contract No.: HHSA290201300003C
Managed and prepared by:
Westat, Rockville, MD
Dale Shalle…
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www.ahrq.gov/sites/default/files/wysiwyg/cahps/cahps-database/2014_hp-chartbook.pdf
January 01, 2014 - 2014 CAHPS Health Plan Survey Database Chartbook
THE CAHPS DATABASE
2014 CAHPS Health Plan
Survey Database
2014 Chartbook: What Consumers Say About Their
Experiences with Their Health Plans and Medical Care
AHRQ Contract No.: HHSA290201300003C
Managed and prepared by:
Westat, Rockville, MD
Dale Shalle…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol1/Grayson.pdf
January 01, 2003 - Do Transient Working Conditions Trigger Medical Errors?
53
Do Transient Working Conditions
Trigger Medical Errors?
Deborah Grayson, Stuart Boxerman, Patricia Potter, Laurie Wolf,
Clay Dunagan, Gary Sorock, Bradley Evanoff
Abstract
Objective: Organizational factors affecting working conditions for health …
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www.ahrq.gov/sites/default/files/2025-03/hinson-levin-report.pdf
January 01, 2025 - Final Progress Report: Connected Emergency Care (CEC) Patient Safety Learning Lab
• Title of Project: Connected Emergency Care (CEC) Patient Safety Learning Lab
• Principal Investigators: Jeremiah S. Hinson, MD, PhD, and Scott R. Levin, PhD
• Team Members: Jeremiah Hinson, MD, PhD, Scott Levin, PhD, Eili Klein, Ph…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol2/Croskerry.pdf
January 01, 2004 - Diagnostic Failure: A Cognitive and Affective Approach
241
Diagnostic Failure: A Cognitive
and Affective Approach
Pat Croskerry
Abstract
Diagnosis is the foundation of medicine. Effective treatment cannot begin until an
accurate diagnosis has been made. Diagnostic reasoning is a critical aspect of
clinic…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol2/Harris.pdf
June 30, 2004 - Mixed Methods Analysis of Medical Error Event Reports: A Report from the ASIPS Collaborative
133
Mixed Methods Analysis of Medical
Error Event Reports: A Report from
the ASIPS Collaborative
Daniel M. Harris, John M. Westfall, Douglas H. Fernald,
Christine W. Duclos, David R. West, Linda Niebauer,
Linda Ma…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol2/Karsh.pdf
April 22, 2004 - Work System Analysis: The Key to Understanding Health Care Systems
337
Work System Analysis: The Key to
Understanding Health Care Systems
Ben-Tzion Karsh, Samuel J. Alper
Abstract
Many articles in the medical literature state that medical errors are the result of
systems problems, require systems analyses, a…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol4/Hundt.pdf
January 01, 2003 - Outpatient Surgery and Patient Safety—The Patient’s Voice
445
Outpatient Surgery and Patient Safety—
The Patient’s Voice
Ann Schoofs Hundt, Pascale Carayon, Scott Springman,
Maureen Smith, Kelly Florek, Rupa Sheth, Margaret Dorshorst
Abstract
Four outpatient surgery centers from a large Midwestern communit…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol2/Advances-Ehringer_17.pdf
February 08, 2008 - Promoting Best Practice and Safety Through Preprinted Physician Orders
Promoting Best Practice and Safety Through
Preprinted Physician Orders
George Ehringer, MD; Barbara Duffy, RN, LHRM, MPH
Abstract
Defining how preprinted physician orders are developed within a hospital has the potential to
positi…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol3/Advances-Davis_60.pdf
April 07, 2008 - Failure Modes and Effects Analysis Based on In Situ Simulations: A Methodology to Improve Understanding of Risks and Failures
Failure Modes and Effects Analysis Based on
In Situ Simulations: A Methodology to Improve
Understanding of Risks and Failures
Stanley Davis, MD; William Riley, PhD; Ayse P. Gurses, PhD; Kr…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol3/Advances-Zierler_81.pdf
September 01, 2008 - Venous Thromboembolism Safety Toolkit: A Systems Approach to Patient Safety
Venous Thromboembolism Safety Toolkit:
A Systems Approach to Patient Safety
Brenda K. Zierler, PhD; Ann Wittkowsky, PharmD; Gene Peterson, MD, PhD;
Jung-Ah Lee, MN; Courtney Jacobson, BA; Robb Glenny, MD; Fred Wolf, PhD;
Lynne Robin…