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2141. Final Progress Report: Creating Learning Cultures Around Mistakes for Residents (pdf file)
      www.ahrq.gov/sites/default/files/2024-02/hoff-report.pdf
      January 01, 2024 - Final Progress Report: Creating Learning Cultures Around Mistakes for Residents 1 Project Title: Creating Learning Cultures Around Mistakes for Residents Timothy J. Hoff, PhD, Principal Investigator University at Albany, SUNY School of Public Health Henry Pohl, MD, Co-Investigator Joel Bartfield, MD, Co-Investi…

2142. Final Progress Report: Midcoast Maine Patient Safety and IT Integration (pdf file)
      www.ahrq.gov/sites/default/files/2024-07/buckley-report.pdf
      January 01, 2024 - Final Progress Report: Midcoast Maine Patient Safety and IT Integration Title: Midcoast Maine Patient Safety and IT Integration Principal Investigator: Maureen Buckle y, PhD, RN – Vice President of Patient Care Team Members: Northeast Health and Partner Organizations Donna Deblois, MS, RN – Executive Dire…

2143. Emergency Nurses Association content and transcript (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/guides/ena-slides.pdf
      September 01, 2015 - Emergency Nurses Association content and transcript AHRQ Safety Program for Reducing CAUTI in Hospitals The Emergency Nurses Association Presents CAUTI Slides and Transcript AHRQ Pub No. 15-0073-5-EF September 2015 Contents Attribution......................................................................…

2144. Final Progress Report: Distance Management of High-Risk Obstetrical Patients (pdf file)
      www.ahrq.gov/sites/default/files/2024-07/ferguson2-report.pdf
      January 01, 2024 - Final Progress Report: Distance Management of High-Risk Obstetrical Patients Project Title: Distance Management of High-Risk Obstetrical Patients Candice Ferguson, MSPH Woman’s Hospital, BR Project Director Stephanie Anderson, BS, CPA Woman’s Hospital, BR Investigator Kim Duplechain…

2145. Part 4: CME Design Features | Agency for Healthcare Research and Quality
      www.ahrq.gov/policymakers/chipra/demoeval/what-we-learned/implementation-guides/implementation-guide2/implguide2pt4.html
      September 01, 2014 - Designing Care Management Entities for Youth with Complex Behavioral Health Needs Part 4: CME Design Features Previous Page Next Page Table of Contents Designing Care Management Entities for Youth with Complex Behavioral Health Needs Part 1: An Introduction to Care Management Entities (CMEs) Par…

2146. 7. Conclusions and Recommendations | Agency for Healthcare Research and Quality
      www.ahrq.gov/healthsystemsresearch/hspc-research-study/conclusions.html
      July 01, 2021 - 7. Conclusions and Recommendations Health Services and Primary Care Research Study: Comprehensive Report Since its emergence as an independent field of study in the 1960s, HSR has helped establish an evidence base to support decisionmaking and improvements in the quality, safety, effectiveness, and efficiency…

2147. Presentation: Building Your SSI Prevention Bundle
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/modules/onboarding/onboarding_build_ssibundle.pptx
      December 01, 2017 - Presentation: Building Your SSI Prevention Bundle Building Your SSI Prevention Bundle AHRQ Safety Program for Surgery Onboarding AHRQ Pub No. 16(18)-0004-15-EF December 2017 SAY: In this module, you’ll learn about using building a local bundle to reduce surgical site infections. 1 Learning Objectives After this se…

2148. 2018 National Healthcare Quality and Disparities Report Detailed Methods for the Medical Expenditure Panel Survey (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/2018qdr-mepsmethods.pdf
      January 01, 2020 - 2018 National Healthcare Quality and Disparities Report Detailed Methods for the Medical Expenditure Panel Survey 2018 NATIONAL HEALTHCARE QUALITY AND DISPARITIES REPORT DETAILED METHODS FOR THE MEDICAL EXPENDITURE PANEL SURVEY U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Agency for Health…

2149. Meeting Minutes (Draft), November 2023 | Agency for Healthcare Research and Quality
      www.ahrq.gov/news/events/nac/2023-11-nac/nacmtg111623-minutes.html
      January 01, 2024 - Meeting Minutes (Draft), November 2023 Minutes from the November 16, 2023, meeting of the Agency for Healthcare Research and Quality's National Advisory Council. Contents Summary Call to Order and Approval of July 12, 2023, Meeting Summary AHRQ Director’s Highlights Consumer Experience Measurement: C…

2150. An Analysis of Nurses' Cognitive Work: A New Perspective for Understanding Medical Errors (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol1/Potter.pdf
      January 01, 2003 - An Analysis of Nurses' Cognitive Work: A New Perspective for Understanding Medical Errors 39 An Analysis of Nurses’ Cognitive Work: A New Perspective for Understanding Medical Errors Patricia Potter, Laurie Wolf, Stuart Boxerman, Deborah Grayson, Jennifer Sledge, Clay Dunagan, Bradley Evanoff Abstract He…

2151. A Model-based Approach to Prioritizing Medical Safety Practices (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol2/Marken.pdf
      January 01, 2004 - A Model-based Approach to Prioritizing Medical Safety Practices 409 A Model-based Approach to Prioritizing Medical Safety Practices Richard S. Marken Abstract This report shows how a model of skilled human performance can be used to evaluate safety practices aimed at reducing medical error when randomized tr…

2152. Using Reported Primary Care Errors to Develop and Implement Patient Safety Interventions: A Report from the ASIPS Collaborative (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol3/West.pdf
      September 01, 2005 - Using Reported Primary Care Errors to Develop and Implement Patient Safety Interventions: A Report from the ASIPS Collaborative 105 Using Reported Primary Care Errors to Develop and Implement Patient Safety Interventions: A Report from the ASIPS Collaborative David R. West, John M. Westfall, Rodrigo Araya-G…

2153. Medical Injury Identification Using Hospital Discharge Data (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol2/Layde.pdf
      January 01, 2003 - Medical Injury Identification Using Hospital Discharge Data 119 Medical Injury Identification Using Hospital Discharge Data Peter M. Layde, Linda N. Meurer, Clare Guse, John R. Meurer, Hongyan Yang, Prakash Laud, Evelyn M. Kuhn, Karen J. Brasel, Stephen W. Hargarten Abstract Objective: Determine the feasi…

2154. Serious Reportable Adverse Events in Health Care (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol4/Kizer2.pdf
      December 01, 2000 - Serious Reportable Adverse Events in Health Care 339 Serious Reportable Adverse Events in Health Care Kenneth W. Kizer, Melissa B. Stegun Abstract Health care errors resulting in patient harm are a leading cause of morbidity and mortality in the United States, although there is no national reporting of such…

2155. A Clinical Assessment Program to Evaluate the Safety of Patient Care (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol4/Snow.pdf
      January 01, 2010 - A Clinical Assessment Program to Evaluate the Safety of Patient Care 57 A Clinical Assessment Program to Evaluate the Safety of Patient Care Richard J. Snow, Martin S. Levine, Dwain L. Harper, Sharon L. McGill, George Thomas, Joseph P. McNerney Abstract The American Osteopathic Association’s Clinical Asses…

2156. The Nature, Characteristics and Patterns of Perinatal Critical Events Teams (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol3/Advances-Riley_58.pdf
      April 02, 2008 - The Nature, Characteristics and Patterns of Perinatal Critical Events Teams The Nature, Characteristics and Patterns of Perinatal Critical Events Teams William Riley, PhD; Helen Hansen, PhD, RN; Ayse P. Gürses, PhD; Stanley Davis, MD; Kristi Miller, RN, MS; Reinhard Priester, JD Abstract The Institute …

2157. The Use of Modest Incentives to Boost Adoption of Safety Practices and Systems (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol3/Advances-Meyer_41.pdf
      March 03, 2008 - The Use of Modest Incentives to Boost Adoption of Safety Practices and Systems The Use of Modest Incentives to Boost Adoption of Safety Practices and Systems Gregg S. Meyer, MD, MSc; David F. Torchiana, MD; Deborah Colton; James Mountford, MB, BCh; Elizabeth Mort, MD; Sarah Lenz; Nancy Gagliano, MD; Elizabet…

2158. Continuous Respiratory Monitoring and a “Smart” Infusion System Improve Safety of Patient-Controlled Analgesia in the Postoperative Period (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol4/Advances-Maddox_111.pdf
      June 18, 2008 - Continuous Respiratory Monitoring and a “Smart” Infusion System Improve Safety of Patient-Controlled Analgesia in the Postoperative Period Continuous Respiratory Monitoring and a “Smart” Infusion System Improve Safety of Patient-Controlled Analgesia in the Postoperative Period Ray R. Maddox, PharmD; Harold Oglesby…

2159. Evaluation of a Medication Therapy Management Program in Medicare Beneficiaries at High Risk of Adverse Drug Events: Study Methods (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol4/Advances-Masica_112.pdf
      November 30, 2010 - Evaluation of a Medication Therapy Management Program in Medicare Beneficiaries at High Risk of Adverse Drug Events: Study Methods Evaluation of a Medication Therapy Management Program in Medicare Beneficiaries at High Risk of Adverse Drug Events: Study Methods Andrew L. Masica, MD, MSc; Daniel R. Touchette, P…

2160. Final Progress Report: TOP-MEDS CERT: Tools for Optimizing Medication Safety (pdf file)
      www.ahrq.gov/sites/default/files/2024-01/lambert-report.pdf
      January 01, 2024 - Instead of treating β and Σ(θ ) as parameters in the frequentist approaches, MAP considers β and γ