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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/854848/psn-pdf
    October 31, 2023 - Delay in Malignancy Diagnosis Reflects Systemic Failures October 31, 2023 Mieu H, Olson KA. Delay in Malignancy Diagnosis Reflects Systemic Failures. PSNet [internet]. 2023. https://psnet.ahrq.gov/web-mm/delay-malignancy-diagnosis-reflects-systemic-failures The Case A 32-year-old man presented to the hospital with…

  2. Final Progress Report: A new approach to the allocation of decisional authority (pdf file)

    www.ahrq.gov/sites/default/files/2024-02/whitney-report.pdf
    January 01, 2024 - Final Progress Report: A new approach to the allocation of decisional authority FINAL REPORT A new approach to the allocation of decisional authority Simon Whitney, MD, JD, Principal Investigator Team members Robert Volk, PhD, vice chair for research, Baylor College of Medicine, Department of Family …

  3. Final Progress Report: Diagnostic Error in Medicine Conference (pdf file)

    www.ahrq.gov/sites/default/files/2025-04/graber-report.pdf
    January 01, 2025 - Final Progress Report: Diagnostic Error in Medicine Conference Final Progress Report Grant Number 1R13HS018321-01 Project Period 8/1/2009 - 1/31/2010 Conference: Diagnostic Error In Medicine PI: Mark L. Graber, MD SUMMARY: This grant was used in support of “Diagnostic Error in Medicine – 2009,” a 2-day confer…

  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33663/psn-pdf
    September 15, 2008 - Implementing a Patient Safety Program at a Large National Health System January 1, 2008 Hauck LD, Jacob J. Implementing a Patient Safety Program at a Large National Health System. PSNet [internet]. 2008. https://psnet.ahrq.gov/perspective/implementing-patient-safety-program-large-national-health-system Perspectiv…

  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/836841/psn-pdf
    June 01, 2020 - The Cleveland Clinic Pairs Advanced Practice Registered Nurses and Paramedics To Provide Home Visits to Recently Discharged Patients at Highest Risk for Hospital Readmission April 7, 2022 https://psnet.ahrq.gov/innovation/cleveland-clinic-pairs-advanced-practice-registered-nurses-and- paramedics-provide-home Sum…

  6. Summary and Discussion | Agency for Healthcare Research and Quality

    www.ahrq.gov/research/findings/final-reports/ptfamilyscan/ptfamily4.html
    July 01, 2018 - Guide to Patient and Family Engagement Summary and Discussion Previous Page Next Page Table of Contents Guide to Patient and Family Engagement Executive Summary Introduction Methods Findings Implications for the Guide Summary and Discussion Next Steps References Appendix A: Draft K…

  7. Facilitator Guide: Build Your SSI Prevention Bundle (doc file)

    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/technical/early-mobility-icu-facguide.docx
    January 01, 2017 - Facilitator Guide: Build Your SSI Prevention Bundle Slide Title and Commentary Slide Number and Slide Title Slide Early Mobility in the Intensive Care Unit SAY: In this slide set, we will look at the benefits, safety, feasibility, and sustainability of early mobility. Many hospitals and intensive care units or IC…

  8. Toolkits | PSNet

    psnet.ahrq.gov/toolkits
    March 01, 2025 - Toolkits Patient safety toolkits provide practical applications of PSNet research and concepts for front line providers to use in their day to day work. These toolkits contain resources necessary to implement patient safety systems and protocols. Want to submit a Toolkit? Has your organization deve…

  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33849/psn-pdf
    January 01, 2018 - In Conversation With… Robert Hirschtick, MD January 1, 2018 In Conversation With… Robert Hirschtick, MD. PSNet [internet]. 2018. https://psnet.ahrq.gov/perspective/conversation-robert-hirschtick-md Editor's note: Dr. Hirschtick is Associate Professor of Medicine at Northwestern Medicine, and the author of a numbe…

  10. Clinical Content Enhancement Toolkit

    hcup-us.ahrq.gov/datainnovations/clinicalcontentenhancementtoolkit/about_grants_cd.jsp
    July 01, 2016 - Clinical Content Enhancement Toolkit An official website of the Department of Health & Human Services Search All AHRQ Websites Careers Contact Us Espanol FAQs Email Updates …

  11. Weight and Height Juxtaposition in the Electronic Medical Record Causing an Accidental Medication Overdose | PSNet

    psnet.ahrq.gov/web-mm/weight-and-height-juxtaposition-electronic-medical-record-causing-accidental-medication
    March 15, 2023 - Weight and Height Juxtaposition in the Electronic Medical Record Causing an Accidental Medication Overdose Citation Text: Jain NP, Dakwa D. Weight and Height Juxtaposition in the Electronic Medical Record Causing an Accidental Medication Overdose. PSNet [internet]. Rockville (MD): Agency for Healthcare Rese…

  12. Appendix U. Improving the Measurement of Surgical Site Infection (SSI) Risk Stratification and Outcome Detection | Agency for Healthcare Research and Quality

    www.ahrq.gov/research/findings/final-reports/ssi/ssiapu.html
    September 01, 2018 - Improving the Measurement of Surgical Site Infection Risk Stratification/Outcome Detection Appendix U. Improving the Measurement of Surgical Site Infection (SSI) Risk Stratification and Outcome Detection Previous Page Next Page Table of Contents Improving the Measurement of Surgical Site Infection R…

  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49437/psn-pdf
    March 01, 2004 - Crossing the Line March 1, 2004 Feldman JP, Gould MK. Crossing the Line. PSNet [internet]. 2004. https://psnet.ahrq.gov/web-mm/crossing-line Case Objectives Review complications of central venous catheterization Discuss patient and operator factors that affect complication rates Describe methods for preventing c…

  14. Periodic Issue | PSNet

    psnet.ahrq.gov/periodic-issue/periodic-issue-469
    December 31, 2024 - January 8, 2025 Weekly Issue PSNet highlights the latest patient safety literature, news, and expert commentary, including Weekly Updates, WebM&M, and Perspectives on Safety. The current issue highlights what's new this week in patient safety literature, news, conferences, reports…

  15. Failure to Rescue | PSNet

    psnet.ahrq.gov/primer/failure-rescue
    September 15, 2024 - Failure to Rescue Citation Text: Tokareva I, Romano P. Failure to Rescue. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2025. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML EndNote 7 XML Endnote tagged PubM…

  16. Patient and Family Engagement in Long Term Care | PSNet

    psnet.ahrq.gov/curated-library/patient-and-family-engagement-long-term-care
    April 10, 2024 - Breadcrumb Home The PSNet Collection Curated Libraries Subscribed Patient and Family Engagement in Long Term Care  Download  Share Facebook Twitter Linkedin Copy URL Subscribe Created By: Lorri Zipperer, C…

  17. Root Cause Analysis Gone Wrong | PSNet

    psnet.ahrq.gov/web-mm/root-cause-analysis-gone-wrong
    August 28, 2024 - Root Cause Analysis Gone Wrong Citation Text: Peerally MF, Dixon-Woods M. Root Cause Analysis Gone Wrong. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2018. Copy Citation Format: Google Scholar BibTeX EndNote X3 XML E…

  18. When the Indications for Drug Administration Blur | PSNet

    psnet.ahrq.gov/web-mm/when-indications-drug-administration-blur
    May 26, 2021 - SPOTLIGHT CASE When the Indications for Drug Administration Blur Citation Text: Munsch J, Doroy A. When the Indications for Drug Administration Blur . PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2020. Copy Citation …

  19. In Conversation With… Charles Vincent, MPhil, PhD | PSNet

    psnet.ahrq.gov/perspective/conversation-charles-vincent-mphil-phd
    July 10, 2024 - In Conversation With… Charles Vincent, MPhil, PhD June 1, 2012  Citation Text: In Conversation With… Charles Vincent, MPhil, PhD. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2012. Copy Ci…

  20. Transforming the Morbidity and Mortality Conference into an Instrument for Systemwide Improvement (pdf file)

    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol2/Advances-Deis_82.pdf
    June 03, 2008 - Transforming the Morbidity and Mortality Conference into an Instrument for Systemwide Improvement Transforming the Morbidity and Mortality Conference into an Instrument for Systemwide Improvement Jamie N. Deis, MD; Keegan M. Smith, MD; Michael D. Warren, MD; Patricia G. Throop, BSN, CPHQ; Gerald B. Hickson, MD; …
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