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psnet.ahrq.gov/node/43932/psn-pdf
March 04, 2015 - Safety considerations to mitigate the risks of
misconnections with small-bore connectors intended for
enteral applications.
March 4, 2015
Rockville, MD: Center for Devices and Radiological Health, US Food and Drug Administration; February
11, 2015.
https://psnet.ahrq.gov/issue/safety-considerations-mitigate-risks…
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psnet.ahrq.gov/node/42915/psn-pdf
January 01, 2016 - Reducing Avoidable Readmissions Effectively campaign:
a statewide collaborative.
February 5, 2014
McCoy KA, Bear-Pfaffendorf K, Foreman JK, et al. Reducing Avoidable Hospital Readmissions Effectively:
A Statewide Campaign. Joint Comm J Qual Patient Saf. 2016;40(5):198-204, AP2. doi:10.1016/s1553-
7250(14)40026-6.
…
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psnet.ahrq.gov/node/44675/psn-pdf
July 05, 2016 - Why July matters.
July 5, 2016
Petrilli CM, Del Valle J, Chopra V. Why July Matters. Acad Med. 2016;91(7):910-912.
doi:10.1097/ACM.0000000000001196.
https://psnet.ahrq.gov/issue/why-july-matters
Studies have reached conflicting conclusions about whether the "July Effect"—the belief that inpatient
mortality increa…
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psnet.ahrq.gov/node/50585/psn-pdf
October 30, 2019 - Introducing the New SOPS Hospital Survey 2.0.
October 30, 2019
Agency for Healthcare Research and Quality. October 30, 2019.
https://psnet.ahrq.gov/issue/updates-hospital-survey-patient-safety-culture
This webinar recording provides information on the updated Hospital Survey on Patient Safety Culture™
(SOPS™) 2.0.…
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digital.ahrq.gov/location/usa-hi-honolulu
January 01, 2023 - USA, HI, Honolulu
Holomua Project-Improving Patient Hand-Offs in Hawaii
Description
Developed approaches to share data on patient clinical and diagnostic information across systems and created an implementation plan for systems integration.
Grant Number
P20 HS015248
…
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digital.ahrq.gov/sites/default/files/docs/citation/r21hs024071-lindquist-final-report-2018.pdf
January 01, 2018 - 155 0.25 1.27 64 2.42 3.22
DME / PT 80 0.13 0.84 28 2.86 2.8
Scheduling 303 0.49 1.89 85 3.56 3.87
Transitions … Lab Order 31 50 33 40.2 0.3097
DME / PT 11 17.7 17 20.7 0.6776
Scheduling 39 62.9 46 56.1 0.4942
Transitions … 1.21 2.25 0.98 2.61 0.5729
DME / PT 0.52 1.72 0.59 1.63 0.8056
Scheduling 2.6 3.73 1.73 3.19 0.1369
Transitions … 9.2) 82 (8.3)
Medication refills 83 (10.5) 80 (8.1)
Appreciation for help 46 (5.8) 77 (7.8)
Care Transitions … medication refills (nc=80, 8.1%;np=83, 10.5%), appreciation for help (nc=77, 7.8%;np=46,
5.8%), care transitions
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digital.ahrq.gov/sites/default/files/docs/workflowtoolkit/IFQHC_operational_redesign_patient_flow_worksheet.pdf
January 01, 2007 - Operational Redesign Through Workflow Analysis
OPERATIONAL REDESIGN
THROUGH WORKFLOW
ANALYSIS
Workbook
apisarski
Text Box
Masspro, Illinois Foundation for Quality Heath Care. Operational Redesign Through Workflow. 2007 [cited 2009 Ju…
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psnet.ahrq.gov/node/839812/psn-pdf
November 09, 2022 - Measuring psychological safety and local learning to
enable high reliability organisational change.
November 9, 2022
Cartland J, Green M, Kamm D, et al. Measuring psychological safety and local learning to enable high
reliability organisational change. BMJ Open Qual. 2022;11(4):e001757. doi:10.1136/bmjoq-2021-00175…
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psnet.ahrq.gov/node/72570/psn-pdf
January 01, 2021 - Provider-patient communication and hospital ratings:
perceived gaps and forward thinking about the effects of
COVID-19.
December 16, 2020
Belasen AT, Hertelendy AJ, Belasen AR, et al. Provider–patient communication and hospital ratings:
perceived gaps and forward thinking about the effects of COVID-19. Int J Qual …
-
psnet.ahrq.gov/node/46816/psn-pdf
March 21, 2018 - Results of an enhanced clinic handoff and resident
education on resident patient ownership and patient
safety.
March 21, 2018
Pincavage A, Dahlstrom M, Prochaska M, et al. Results of an enhanced clinic handoff and resident
education on resident patient ownership and patient safety. Acad Med. 2013;88(6):795-801.
d…
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psnet.ahrq.gov/node/73487/psn-pdf
July 14, 2021 - The July Effect in podiatric medicine and surgery
residency.
July 14, 2021
Casciato DJ, Thompson J, Law R, et al. The July Effect in podiatric medicine and surgery residency. J Foot
Ankle Surg. 2021;60(6):1152-1157. doi:10.1053/j.jfas.2021.04.020.
https://psnet.ahrq.gov/issue/july-effect-podiatric-medicine-and-sur…
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www.ahrq.gov/pqmp/measures/fecc-child-written-transition-plan.html
August 01, 2021 - Family Experiences with Coordination of Care (FECC) Measure: Child has written transition plan
Measure Domain: Management of Chronic Conditions
Measure Sub-Domain: Care Coordination
PQMP COE: COE4CCN
Associated NQF # and Name: None
Products:
Fact Sheet (PDF, 684 KB)
Full Report (PDF, 156.6 KB)…
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psnet.ahrq.gov/node/47308/psn-pdf
December 21, 2018 - Improving pediatric electronic health record usability and
safety through certification: seize the day.
December 21, 2018
Ratwani RM, Moscovitch B, Rising JP. Improving Pediatric Electronic Health Record Usability and Safety
Through Certification: Seize the Day. JAMA Pediatr. 2018;172(11):1007-1008.
doi:10.1001/ja…
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psnet.ahrq.gov/node/47478/psn-pdf
January 16, 2019 - Prospective daily review of discharge medications by
pharmacists: effects on measures of safety and
efficiency.
January 16, 2019
Craynon R, Hager DR, Reed M, et al. Prospective daily review of discharge medications by pharmacists:
Effects on measures of safety and efficiency. Am J Health Syst Pharm. 2018;75(19):14…
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www.ahrq.gov/ncepcr/research/care-coordination/index.html
September 01, 2022 - Care Coordination
Care coordination, a key element for delivery of quality primary care, involves deliberately organizing patient care activities and sharing information among all of the participants concerned with a patient's care to achieve safer and more effective care. This means that the patient's needs an…
-
hcup-us.ahrq.gov/datainnovations/clinicalcontentenhancementtoolkit/mn19.pdf
June 21, 2014 - MHA/AHRQ Clinically Enhanced Data Project
ENROLL NOW!
Your Hospital gains
Comparative Analysis
Compare your risk-adjusted
outcomes to other hospitals
Improve pharmacological
management of patients
with Acute Decompensated
Heart Failure (ADHF)
Framework for other priority
initiatives such as: p…
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psnet.ahrq.gov/node/49563/psn-pdf
May 01, 2008 - Is It Safe to Be Direct?
May 1, 2008
Kulkarni NS, Williams M. Is It Safe to Be Direct? PSNet [internet]. 2008.
https://psnet.ahrq.gov/web-mm/it-safe-be-direct
The Case
A 92-year-old man with hypertension and heart failure (HF) was evaluated by his primary care physician
(PCP) for progressive shortness of breat…
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hcup-us.ahrq.gov/db/nation/nis/NISChangesBeginningDataYr2016.pdf
September 01, 2022 - NISChangesBeginningDataYr2016
HEALTHCARE COST AND UTILIZATION PROJECT (HCUP)
NATIONAL INPATIENT SAMPLE:
CHANGE IN STRUCTURE DUE TO ICD-10-CM/PCS
BEGINNING WITH 2016 DATA
Recommended Citation: Barrett ML, Hensche MB, Welch J, Ross DN. Healthcare Cost
and Utilization Project (HCUP) National Inpatient Sample: C…
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psnet.ahrq.gov/node/74748/psn-pdf
February 09, 2022 - The abrupt expansion of ambulatory telemedicine:
implications for patient safety.
February 9, 2022
Khoong EC, Sharma AE, Gupta K, et al. The abrupt expansion of ambulatory telemedicine: implications for
patient safety. J Gen Intern Med. 2022;37(5):1270-1274. doi:10.1007/s11606-021-07329-9.
https://psnet.ahrq.gov/i…
-
psnet.ahrq.gov/node/851356/psn-pdf
July 12, 2023 - Leveraging the science of teamwork to sustain handoff
improvements in cardiovascular surgery.
July 12, 2023
Keebler JR, Lynch I, Ngo F, et al. Leveraging the science of teamwork to sustain handoff improvements in
cardiovascular surgery. Jt Comm J Qual Patient Saf. 2023;49(8):373-383. doi:10.1016/j.jcjq.2023.05.006.…