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  1. In Conversation with...Lucian Leape, MD | PSNet

    psnet.ahrq.gov/perspective/conversation-withlucian-leape-md
    August 01, 2006 - implement safe practices here in Massachusetts: reconciling medications and communicating critical test

  2. Resilient Healthcare and the Safety-I and Safety-II Frameworks | PSNet

    psnet.ahrq.gov/perspective/resilient-healthcare-and-safety-i-and-safety-ii-frameworks
    December 14, 2022 - Sarah Mossburg: It sounds like simulation really allows people to test adaptations to situations and

  3. In Conversation With… Nicholas G. Castle, MHA, PhD | PSNet

    psnet.ahrq.gov/perspective/conversation-nicholas-g-castle-mha-phd
    August 01, 2012 - relevant medical conditions, concurrent medications, potential drug interactions, and pertinent laboratory test

  4. Building a Safety Program in a Vast Health Care Network | PSNet

    psnet.ahrq.gov/perspective/building-safety-program-vast-health-care-network
    March 01, 2019 - So suddenly the formulary changes, some biomedical equipment changes, a test or radiology reporting system

  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/836941/psn-pdf
    April 27, 2022 - Demonstration, the CMS Innovation Center worked with select medical practices around the country to test

  6. Post-Acute Transitional Services: Safety in Home-Based Care Programs | PSNet

    psnet.ahrq.gov/primer/post-acute-transitional-services-safety-home-based-care-programs
    April 24, 2024 - Demonstration, the CMS Innovation Center worked with select medical practices around the country to test

  7. Changes-Medication-Safety-Indicators-England-Throughout-Covid-19-Pandemic-Using-Opensafely

    psnet.ahrq.gov/issue/changes-medication-safety-indicators-england-throughout-covid-19-pandemic-using-opensafely
    October 19, 2022 - psnet

  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/866578/psn-pdf
    August 28, 2024 - Don’t Wait to Collect an Accurate Weight: A Case of Subtherapeutic Insulin Therapy August 28, 2024 Newton B, Seitz R. Don’t Wait to Collect an Accurate Weight: A Case of Subtherapeutic Insulin Therapy. PSNet [internet]. 2024. https://psnet.ahrq.gov/web-mm/dont-wait-collect-accurate-weight-case-subtherapeutic-insul…

  9. Cognitive Overload in the ICU | PSNet

    psnet.ahrq.gov/web-mm/cognitive-overload-icu
    June 01, 2005 - SPOTLIGHT CASE Cognitive Overload in the ICU Citation Text: Patel VL, Buchman TG. Cognitive Overload in the ICU. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2016. Copy Citation Format: Google Scholar BibTe…

  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49831/psn-pdf
    June 01, 2018 - Chest Pain in a Rural Hospital June 1, 2018 MacKinney CA, Mohr NM. Chest Pain in a Rural Hospital. PSNet [internet]. 2018. https://psnet.ahrq.gov/web-mm/chest-pain-rural-hospital Case Objectives Recognize that a significant proportion of the Unites States population receives care in rural safety net emergency dep…

  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49801/psn-pdf
    August 01, 2017 - Despite Clues, Failed to Rescue August 1, 2017 Ghaferi AA. Despite Clues, Failed to Rescue. PSNet [internet]. 2017. https://psnet.ahrq.gov/web-mm/despite-clues-failed-rescue Case Objectives Define failure to rescue. Identify the main contributors to failure-to-rescue events. Appreciate the ongoing areas of scien…

  12. The Forgotten Turn | PSNet

    psnet.ahrq.gov/web-mm/forgotten-turn
    August 01, 2018 - SPOTLIGHT CASE The Forgotten Turn Citation Text: Barbour S. The Forgotten Turn. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2010. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML En…

  13. Spotlight (pdf file)

    psnet.ahrq.gov/sites/default/files/2020-05/final_may-spotlight-fatal_pca_slides_05.01.2020_cme_review-revised.pdf
    January 01, 2020 - Spotlight Spotlight Fatal PCA Opioid-Induced Respiratory Depression Source and Credits • This presentation is based on the May 2020 AHRQ WebM&M Spotlight Case o See the full article at https://psnet.ahrq.gov/webmm • Commentary by: Sarina Fazio, PhD, RN and Rachelle Firestone, PharmD, BCCCP o Editors in Chie…

  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/863649/psn-pdf
    February 28, 2024 - In Conversation With...Stephen Hines, PhD and Monika Haugstetter, MHA, MSN, RN, CPHQ about TeamSTEPPS 3.0 February 28, 2024 In Conversation With..Stephen Hines, PhD and Monika Haugstetter, MHA, MSN, RN, CPHQ about TeamSTEPPS 3.0. PSNet [internet]. 2024. https://psnet.ahrq.gov/perspective/conversation-withstephen-…

  15. In Conversation With… Paul Aylin, MBChB | PSNet

    psnet.ahrq.gov/perspective/conversation-paul-aylin-mbchb
    June 01, 2017 - In Conversation With… Paul Aylin, MBChB June 1, 2017  Also Read an Essay Citation Text: In Conversation With… Paul Aylin, MBChB. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2017. Copy …

  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49753/psn-pdf
    February 01, 2016 - Robotic Surgery: Risks vs. Rewards February 1, 2016 Kirkpatrick T, LaGrange C. Robotic Surgery: Risks vs. Rewards. PSNet [internet]. 2016. https://psnet.ahrq.gov/web-mm/robotic-surgery-risks-vs-rewards Case Objectives Discuss the background and current trends in robotic surgery. Identify the benefits of robotic s…

  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33828/psn-pdf
    March 01, 2017 - In Conversation With… Mary Dixon-Woods, DPhil March 1, 2017 In Conversation With… Mary Dixon-Woods, DPhil. PSNet [internet]. 2017. https://psnet.ahrq.gov/perspective/conversation-mary-dixon-woods-dphil Editor's note: Dr. Dixon-Woods is RAND Professor of Health Services Research at Cambridge University and Deputy …

  18. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33708/psn-pdf
    March 01, 2011 - In Conversation with…Vineet Arora, MD, MA March 1, 2011 In Conversation with…Vineet Arora, MD, MA . PSNet [internet]. 2011. https://psnet.ahrq.gov/perspective/conversation-withvineet-arora-md-ma Editor's note: Vineet Arora, MD, MA, is Associate Program Director for the Internal Medicine Residency and Assistant Dea…

  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49491/psn-pdf
    September 01, 2005 - Time of Death? September 1, 2005 Taekman JM, Wright MC. Time of Death? PSNet [internet]. 2005. https://psnet.ahrq.gov/web-mm/time-death The Case An 80-year-old woman with multiple illnesses, including chronic obstructive pulmonary disease (COPD), was found pulseless and cyanotic in her hospital bed. A code was ca…

  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/837748/psn-pdf
    August 05, 2022 - Challenges of Diabetes Management and Medication Reconciliation August 5, 2022 Lee S, Molla M. Challenges of Diabetes Management and Medication Reconciliation . PSNet [internet]. 2022. https://psnet.ahrq.gov/web-mm/challenges-diabetes-management-and-medication-reconciliation The Cases Case #1: A 53-year-old man …
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