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psnet.ahrq.gov/issue/organizational-and-intraorganizational-development-disasters
May 12, 2021 - Review
Classic
The organizational and intraorganizational development of disasters.
Citation Text:
Turner BA. The Organizational and Interorganizational Development of Disasters. Adm Sci Q. 1976;21(3):378. doi:10.2307/2391850.
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psnet.ahrq.gov/issue/learning-safe-prescribing-during-post-take-ward-rounds
August 14, 2013 - Newspaper/Magazine Article
Learning safe prescribing during post-take ward rounds.
Citation Text:
Conroy-Smith E, Herring R, Caldwell G. Learning safe prescribing during post-take ward rounds. The clinical teacher. 2011;8(2):75-8. doi:10.1111/j.1743-498X.2011.00432.x.
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psnet.ahrq.gov/issue/improving-self-reporting-adverse-drug-events-west-virginia-hospital
March 10, 2011 - Study
Improving self-reporting of adverse drug events in a West Virginia hospital.
Citation Text:
Schade CP, Hannah K, Ruddick P, et al. Improving self-reporting of adverse drug events in a West Virginia hospital. Am J Med Qual. 2006;21(5):335-41.
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psnet.ahrq.gov/issue/new-solutions-reduce-wrong-route-medication-errors
March 20, 2019 - Review
New solutions to reduce wrong route medication errors.
Citation Text:
Litman RS, Smith VI, Mainland P. New solutions to reduce wrong route medication errors. Paediatr Anaesth. 2018;28(1):8-12. doi:10.1111/pan.13279.
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psnet.ahrq.gov/issue/hospitalization-associated-disability-she-was-probably-able-ambulate-im-not-sure
August 04, 2015 - Study
Hospitalization-associated disability: "She was probably able to ambulate, but I'm not sure."
Citation Text:
Covinsky KE, Pierluissi E, Johnston B. Hospitalization-associated disability: "She was probably able to ambulate, but I'm not sure". JAMA. 2011;306(16):1782-93. doi:10.1001…
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www.ahrq.gov/policymakers/chipra/cpcf-form9.html
December 01, 2013 - Candidate Measure Submission Form (CPCF)
CHIPRA Pediatric Quality Measures Program (PQMP)
The CHIPRA Pediatric Quality Measures Program (PQMP) Candidate Measure Submission Form (CPCF) was approved by the Office of Management and Budget (OMB) in accordance with the Paperwork Reduction Act. The OMB Control Num…
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psnet.ahrq.gov/issue/how-we-cut-drug-errors
August 19, 2020 - Newspaper/Magazine Article
How we cut drug errors.
Citation Text:
Nicol N, Huminski L. How we cut drug errors. At one hospital, IT and changed culture saves lives. Modern healthcare. 2006;36(34):38.
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psnet.ahrq.gov/issue/minimizing-surgical-error-incorporating-objective-assessment-surgical-education
January 12, 2022 - Review
Minimizing surgical error by incorporating objective assessment into surgical education.
Citation Text:
Champion HR, Meglan DA, Shair EK. Minimizing Surgical Error by Incorporating Objective Assessment into Surgical Education. J Am Coll Surg. 2008;207(2). doi:10.1016/j.jamcollsu…
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www.ahrq.gov/hai/cauti-tools/archived-webinars/aseptic-catheter-insertion-practices-ed-slides.html
December 01, 2017 - Aseptic Catheter Insertion Practices in the ED: A Focus on Engagement
Slide Presentation
Slide 1
Aseptic Catheter Insertion Practices in the ED: A Focus on Engagement
Milisa Manojlovich PhD, RN, CCRN
Associate Professor
University of Michigan, School of Nursing
Slide 2
Learning Objectives
Di…
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psnet.ahrq.gov/issue/nurses-medication-work-what-do-nurses-know
September 20, 2023 - Review
Nurses' medication work: what do nurses know?
Citation Text:
Folkmann L, Rankin J. Nurses' medication work: what do nurses know? J Clin Nurs. 2010;19(21-22):3218-26. doi:10.1111/j.1365-2702.2010.03249.x.
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psnet.ahrq.gov/issue/citing-harms-momentum-grows-remove-race-clinical-algorithms
January 31, 2011 - Commentary
Citing harms, momentum grows to remove race from clinical algorithms.
Citation Text:
Kuehn BM. Citing harms, momentum grows to remove race from clinical algorithms. JAMA. 2024;331(6):463-465. doi:10.1001/jama.2023.25530.
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psnet.ahrq.gov/issue/10-leadership-mindsets-high-reliability-organizations-how-empower-caregivers-and-engage
August 12, 2020 - Newspaper/Magazine Article
10 Leadership mindsets for high reliability organizations. How to empower caregivers and engage patients in patient safety.
Citation Text:
10 Leadership mindsets for high reliability organizations. How to empower caregivers and engage patients in patient safety…
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psnet.ahrq.gov/issue/daily-dose-communication-improve-quality-and-safety-outcomes
September 15, 2009 - Review
A daily dose of communication to improve quality and safety outcomes.
Citation Text:
Halm MA. A daily dose of communication to improve quality and safety outcomes. Am J Crit Care. 2024;33(4):305-310. doi:10.4037/ajcc2024318.
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psnet.ahrq.gov/issue/can-aviation-industry-be-useful-teaching-oncology-about-safety
June 13, 2011 - Commentary
Can the aviation industry be useful in teaching oncology about safety?
Citation Text:
Davies JM, Delaney G. Can the Aviation Industry be Useful in Teaching Oncology about Safety? Clin Oncol (R Coll Radiol). 2017;29(10):669-675. doi:10.1016/j.clon.2017.06.007.
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psnet.ahrq.gov/issue/interprofessional-conflict-and-medical-errors-results-national-multi-specialty-survey
July 10, 2017 - Study
Interprofessional conflict and medical errors: results of a national multi-specialty survey of hospital residents in the US.
Citation Text:
Baldwin DC, Daugherty SR. Interprofessional conflict and medical errors: results of a national multi-specialty survey of hospital residents …
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psnet.ahrq.gov/issue/how-deal-disruptive-physician-behavior
December 02, 2020 - Commentary
How to "DEAL" with disruptive physician behavior.
Citation Text:
Junga Z, Tritsch A, Singla M. How to “DEAL” With disruptive physician behavior. Gastroenterology. 2019;157(6):1469-1472. doi:10.1053/j.gastro.2019.10.021.
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www.ahrq.gov/news/newsroom/case-studies/ktcquips82.html
October 01, 2014 - Five Nebraska Hospitals Use AHRQ Toolkit to Improve Medication Reconciliation Across Care Settings
Search All Impact Case Studies
November 2011
Between January and September 2010, AHRQ partnered with seven Quality Improvement Organizations (QIOs) to deliver a series of onsite learning sessions and provider …
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www.ahrq.gov/research/findings/final-reports/advisorycouncil/adcouncilapb.html
April 01, 2018 - Guide for Developing a Community-Based Patient Safety Advisory Council
Appendix B. Council Information Sheet and Application
A sample of the member information sheet and application for patients or caregivers for the Aurora Health Care Patient Safety Partnership Council follows. With minor edits, the informat…
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psnet.ahrq.gov/issue/workplace-bullying-risk-and-safety-professionals
May 05, 2021 - Study
Workplace bullying in risk and safety professionals.
Citation Text:
Brewer G, Holt B, Malik S. Workplace bullying in risk and safety professionals. J Safety Res. 2018;64:129-133. doi:10.1016/j.jsr.2017.12.015.
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psnet.ahrq.gov/issue/case-study-safety-impact-implementing-smart-patient-controlled-analgesic-pumps-tertiary-care
August 31, 2016 - Study
A case study on the safety impact of implementing smart patient-controlled analgesic pumps at a tertiary care academic medical center.
Citation Text:
Tran M, Ciarkowski S, Wagner D, et al. A case study on the safety impact of implementing smart patient-controlled analgesic pumps at…