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  1. effectivehealthcare.ahrq.gov/sites/default/files/related_files/mhs-IV-patient-family-engagement.pdf
    July 01, 2023 - EHC Protocol: Addressing Social Isolation To Improve Health of Older Adults: A Rapid Evidence Review Evidence-based Practice Center Rapid Response Protocol Project Title: Making Healthcare Safer IV: Patient and Family Engagement Review Questions 1. What is the frequency and severity of harms addre…
  2. digital.ahrq.gov/sites/default/files/docs/publication/r21hs021794-lakshiminarayan-final-report-2015.pdf
    January 01, 2015 - Promoting Self-Management in Stroke Survivors Using Health-IT - Final Report Promoting Self-Management in Stroke Survivors Using Health-IT AHRQ R21 HS21794 Principal Investigator: Kamakshi Lakshminarayan MBBS, PhD, MS (kamakshi@umn.edu) Co-investigators: Sarah Westberg PharmD, David Pieczkiewicz PhD, Farah …
  3. psnet.ahrq.gov/web-mm/navigating-chaos-fatal-iatrogenic-liver-injury-patient-admitted-leg-fractures
    November 27, 2019 - Navigating Chaos: Fatal Iatrogenic Liver Injury in a Patient Admitted for Leg Fractures Citation Text: Loseth C. Navigating Chaos: Fatal Iatrogenic Liver Injury in a Patient Admitted for Leg Fractures. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and …
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33785/psn-pdf
    May 01, 2015 - In Conversation With… John D. Birkmeyer, MD May 1, 2015 In Conversation With… John D. Birkmeyer, MD. PSNet [internet]. 2015. https://psnet.ahrq.gov/perspective/conversation-john-d-birkmeyer-md Editor's note: John D. Birkmeyer, MD, is an internationally recognized health services researcher with expertise in perfo…
  5. psnet.ahrq.gov/web-mm/errors-sepsis-management
    November 03, 2015 - SPOTLIGHT CASE Errors in Sepsis Management Citation Text: Shimabukuro D. Errors in Sepsis Management. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2015. Copy Citation Format: Google Scholar BibTeX EndNote X…
  6. Spotlight (pdf file)

    psnet.ahrq.gov/sites/default/files/2020-03/final_spotlight_case_delays_in_the_ed_powerpoint_for_cme_review_03.09.2020.pdf
    January 01, 2020 - Spotlight Spotlight Some Patients Can’t Wait: Improving Timeliness of Emergency Department Care Source and Credits • This presentation is based on the 2020 AHRQ WebM&M Spotlight Case ○ See the full article at https://psnet.ahrq.gov/webmm • Commentary by: David K. Barnes, MD, FACEP and Rita Chang, MD ○ Editor…
  7. www.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/cusptoolkit/modules/patfamilyengagement/CUSP_Patient_Family_Engagement_Facilitator_Notes.docx
    June 02, 2025 - SAY: The Patient and Family Engagement module of the Comprehensive Unit-based Safety Program (or CUSP) Toolkit focuses on an important topic: Making sure patients and their family members understand what is happening during the patient’s hospital stay, are active participants in the patient’s care, and are prepared for…
  8. www.ahrq.gov/sites/default/files/wysiwyg/npsd/npsd-portfolios-summary-profile-2014.pdf
    January 01, 2014 - Patient Safety Organizations: A Summary of 2014 Profiles Patient Safety Organizations: A Summary of 2014 Profiles The safety of patients in health care settings remains a national priority and an important challenge. The Patient Safety Organization (PSO) program, which was authorized by the Patient Safety and Qu…
  9. psnet.ahrq.gov/perspective/conversation-andrew-bindman-md
    June 15, 2024 - In Conversation With… Andrew Bindman, MD November 1, 2016  Citation Text: In Conversation With… Andrew Bindman, MD. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2016. Copy Citation For…
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49858/psn-pdf
    April 01, 2019 - What Happened on Telemetry? April 1, 2019 Sandau KE, Funk M. What Happened on Telemetry? PSNet [internet]. 2019. https://psnet.ahrq.gov/web-mm/what-happened-telemetry Case Objectives Describe current hospital practices for continuous telemetry monitoring. Appreciate key recommendations from the Update to Practice…
  11. www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/pu1.html
    October 01, 2014 - Preventing Pressure Ulcers in Hospitals 1. Are we ready for this change? Previous Page Next Page Table of Contents Preventing Pressure Ulcers in Hospitals Overview Key Subject Area Index 1. Are we ready for this change? 2. How will we manage change? 3. What are the best practices in pressu…
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/865540/psn-pdf
    April 11, 2024 - Misplaced Nasogastric Tube Resulting in Aspiration April 11, 2024 Singh A, Huang C. Misplaced Nasogastric Tube Resulting in Aspiration. PSNet [internet]. 2024. https://psnet.ahrq.gov/web-mm/misplaced-nasogastric-tube-resulting-aspiration The Case An 82-year-old woman presented to the Emergency Department (ED) for …
  13. www.ahrq.gov/research/findings/nhqrdr/chartbooks/carecoordination/measure5.html
    June 01, 2018 - Chartbook on Care Coordination Use of Electronic Health Records Previous Page Next Page Table of Contents Chartbook on Care Coordination Acknowledgments Care Coordination Trends in Care Coordination Measures Transitions of Care Preventable Emergency Department Visits Potentially Avoidabl…
  14. psnet.ahrq.gov/innovation/verification-screen-includes-prominent-patient-photograph-significantly-reduces-errors
    October 30, 2024 - Verification Screen That Includes Prominent Patient Photograph Significantly Reduces Errors Caused by Orders Placed in Wrong Chart Save Save to your library Print Download PDF Share Facebook Twitter Linkedin Copy URL June 12, 2020 …
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49771/psn-pdf
    July 01, 2016 - Unintended Consequences of CPOE October 1, 2016 Wears RL. Unintended Consequences of CPOE. PSNet [internet]. 2016. https://psnet.ahrq.gov/web-mm/unintended-consequences-cpoe Case Objectives Explain how technology, including computerized provider order entry, can transform, rather than eliminate, hazards. Recogni…
  16. www.ahrq.gov/hai/tools/surgery/modules/on-boarding/build-ssi-bundle-fac-notes.html
    December 01, 2017 - Building Your SSI Prevention Bundle: Facilitator Notes AHRQ Safety Program for Surgery Slide 1: Building Your SSI Prevention Bundle Say: In this module, you’ll learn about using building a local bundle to reduce surgical site infections. Slide 2: Learning Objectives Say: After reviewing this mod…
  17. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/modules/onboarding/onboarding_build_ssibundle_facnotes.docx
    December 01, 2017 - Facilitator Guide: Building Your SSI Prevention Bundle Slide Title and Commentary Slide Number and Slide Title Slide Building Your Surgical Site Infection Prevention Bundle SAY: In this module, you’ll learn about using building a local bundle to reduce surgical site infections. Slide 1 Learning Objectives SA…
  18. www.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/situ/simulation-fac-guide.html
    July 01, 2023 - Establishing a Program of In Situ Simulations: Facilitator Guide AHRQ Safety Program for Perinatal Care Slide 1: Establishing a Program of In Situ Simulations Say: Establishing a Program of In Situ Simulations is a pillar of the AHRQ Safety Program for Perinatal Care. This module introduces in situ simu…
  19. Simulation Facguide (doc file)

    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/situ/simulation_facguide.docx
    May 01, 2017 - AHRQ Safety Program for Perinatal Care Establishing a Program of In Situ Simulations Establishing a Program of In Situ Simulations SAY: Establishing a Program of In Situ Simulations is a pillar of the AHRQ Safety Program for Perinatal Care. This module introduces in situ simulation and discusses the use of in situ sim…
  20. www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/resources/tools/prevent/clinical-faqs.docx
    March 01, 2017 - BLADDER SCAN – POLICY #2202 12/11/06 AHRQ Safety Program for Long-Term Care: HAIs/CAUTI AHRQ Safety Program for Reducing CAUTI in Hospitals Appendix F. CAUTI Prevention in Long-Term Care Frequently Asked Questions The frequently asked questions (FAQs) are intended to support facilities in the implementation of cathe…