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psnet.ahrq.gov/issue/measuring-safety-climate-elderly-homes
March 29, 2023 - Study
Measuring safety climate in elderly homes.
Citation Text:
Yeung K-C, Chan CC. Measuring safety climate in elderly homes. J Safety Res. 2012;43(1):9-20. doi:10.1016/j.jsr.2011.10.009.
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psnet.ahrq.gov/issue/education-service-partnership-achieve-safety-and-quality-improvement-competencies-nursing
August 30, 2023 - Commentary
An education-service partnership to achieve safety and quality improvement competencies in nursing.
Citation Text:
Fater KH, Ready R. An Education-Service Partnership to Achieve Safety and Quality Improvement Competencies in Nursing. Journal of Nursing Education. 2011;50(12).…
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psnet.ahrq.gov/issue/trainees-voice-recognising-importance-preoperative-briefings-surgical-trainees
October 09, 2019 - Commentary
The trainee's voice: recognising the importance of preoperative briefings for surgical trainees.
Citation Text:
Bethune R, Blencowe NS. The trainee's voice: recognising the importance of preoperative briefings for surgical trainees. J Perioper Pract. 2014;24(3):56-58.
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psnet.ahrq.gov/issue/how-safe-my-intensive-care-unit-overview-error-causation-and-prevention
November 25, 2020 - Review
How safe is my intensive care unit? An overview of error causation and prevention.
Citation Text:
Valentin A, Bion J. How safe is my intensive care unit? An overview of error causation and prevention. Curr Opin Crit Care. 2007;13(6):697-702.
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psnet.ahrq.gov/issue/using-morbidity-and-mortality-conferences-drive-quality-improvement-and-reduce-errors
February 04, 2015 - Commentary
Using morbidity and mortality conferences to drive quality improvement and reduce errors.
Citation Text:
Using morbidity and mortality conferences to drive quality improvement and reduce errors. Lai B, Horn J, Wilkinson J, et al. Fam Pract Manag. 2023;30(2):13-17.
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psnet.ahrq.gov/issue/effect-comprehensive-obstetric-patient-safety-program-compensation-payments-and-sentinel
July 26, 2010 - Study
Effect of a comprehensive obstetric patient safety program on compensation payments and sentinel events.
Citation Text:
Grunebaum A, Chervenak F, Skupski D. Effect of a comprehensive obstetric patient safety program on compensation payments and sentinel events. Am J Obstet Gyneco…
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psnet.ahrq.gov/issue/continuous-improvement-ideal-health-care
August 04, 2021 - Commentary
Classic
Continuous improvement as an ideal in health care.
Citation Text:
Berwick D. Continuous improvement as an ideal in health care. New Engl J Med. 1989;320(1):53-56.
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psnet.ahrq.gov/issue/delivering-high-reliability-maternity-care-situ-simulation-source-organisational-resilience
April 05, 2023 - Commentary
Emerging Classic
Delivering high reliability in maternity care: in situ simulation as a source of organisational resilience.
Citation Text:
Macrae C, Draycott T. Delivering high reliability in maternity care: In situ simulation as a source of organisa…
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www.ahrq.gov/cahps/surveys-guidance/item-sets/literacy/index.html
December 01, 2022 - CAHPS Health Literacy Item Sets
The CAHPS Health Literacy Item Sets ask about providers' efforts to foster and improve the health literacy of patients. Health literacy is commonly defined as patients' ability to obtain, process, and understand the basic health information and services they need to make appropri…
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www.ahrq.gov/news/newsroom/case-studies/201526.html
January 01, 2018 - Iowa’s Waverly Health Center Uses AHRQ Tools to Improve Patient Safety
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September 2015
Waverly Health Center, a critical access hospital in Waverly, Iowa, has used three AHRQ resources to improve communication, teamwork, and leadership engagement as part of ongoing efforts to i…
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psnet.ahrq.gov/issue/medical-device-use-error-root-cause-analysis
January 10, 2018 - Book/Report
Medical Device Use Error: Root Cause Analysis.
Citation Text:
Medical Device Use Error: Root Cause Analysis. Wiklund M, Dwyer A, Davis E. Boca Raton, FL: CRC Press; 2015. ISBN: 9781498705790.
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psnet.ahrq.gov/issue/medical-error-and-human-factors-engineering-where-are-we-now
August 04, 2021 - Review
Medical error and human factors engineering: where are we now?
Citation Text:
Gawron VJ, Drury CG, Fairbanks RJ, et al. Medical error and human factors engineering: where are we now? Am J Med Qual. 2006;21(1):57-67.
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psnet.ahrq.gov/issue/professionalism-lapses-and-adverse-childhood-experiences-reflections-island-last-resort
October 14, 2015 - Commentary
Professionalism lapses and adverse childhood experiences: reflections from the island of last resort.
Citation Text:
Williams BW. Professionalism Lapses and Adverse Childhood Experiences: Reflections From the Island of Last Resort. Acad Med. 2019;94(8):1081-1083. doi:10.1097/A…
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psnet.ahrq.gov/issue/adverse-events-hospitals-quarter-medicare-patients-experienced-harm-october-2018
February 01, 2023 - Book/Report
Adverse Events in Hospitals: A Quarter of Medicare Patients Experienced Harm in October 2018.
Citation Text:
Adverse Events in Hospitals: A Quarter of Medicare Patients Experienced Harm in October 2018. Grimm CA. Washington DC: Office of the Inspector General; May 2022. Repor…
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psnet.ahrq.gov/issue/aiming-higher-enhance-professionalism-beyond-accreditation-and-certification
February 03, 2011 - Commentary
Aiming higher to enhance professionalism: beyond accreditation and certification.
Citation Text:
Chassin MR, Baker DW. Aiming higher to enhance professionalism: beyond accreditation and certification. JAMA. 2015;313(18):1795-6. doi:10.1001/jama.2015.3818.
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psnet.ahrq.gov/issue/nursing-2006-patient-safety-survey-report
March 01, 2023 - Study
Nursing 2006 Patient-safety survey report.
Citation Text:
Manno M, Hogan P, Heberlein V, et al. Nursing 2006. Patient-safety survey report. Nursing (Brux). 2006;36(5):54-64.
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digital.ahrq.gov/program-overview/research-stories/machine-learning-algorithm-improve-use-interpreters-hospitalized
January 01, 2023 - A Machine Learning Algorithm to Improve the Use of Interpreters for Hospitalized Patients with Complex Care Needs
Theme:
Supporting Health Systems in Advancing Care Delivery
Subtheme:
Improving Equity in Healthcare with Digital Healthcare Solutions
A machine learning, predictive analytic i…
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www.ahrq.gov/news/newsroom/case-studies/201903.html
April 01, 2019 - Johns Hopkins Children’s Center Uses AHRQ-Funded I-PASS Tool to Boost Patient Safety
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April 2019
Pediatric residents at Johns Hopkins Children’s Center in Baltimore, MD, changed the way they handed off patients between shift changes by closely adhering—sometimes by as much as …
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psnet.ahrq.gov/issue/support-methods-healthcare-professionals-who-are-second-victims-integrative-review
April 27, 2022 - Review
Support methods for healthcare professionals who are second victims: an integrative review.
Citation Text:
Support methods for healthcare professionals who are second victims: an integrative review. Neft MW, Sekula K, Zoucha R, et al. AANA J. 2022;90(3):189-196.
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psnet.ahrq.gov/issue/ensuring-medication-safety-consumers-ethnic-minority-backgrounds-need-address-unconscious
July 29, 2020 - Commentary
Ensuring medication safety for consumers from ethnic minority backgrounds: the need to address unconscious bias within health systems.
Citation Text:
Chauhan A, Walpola RL. Ensuring medication safety for consumers from ethnic minority backgrounds: the need to address unconscio…