-
www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/quality-measures/qsrs/qsrs-2021-2022-adverse-event-data-report-nov-rev.pdf
January 01, 2022 - Venous
Thromboembolism (VTE)
Deep vein thrombosis (DVT) without pulmonary
embolism (PE)
PE without … Thromboembolism
(VTE)
7 3373 0.2 0.1 –
0.4
58 18276 0.3 0.3 –
0.4
Deep vein thrombosis
( … At Risk
AE
Rate
(%) 95% CI
Venous
Thromboembolism
(VTE)
29 11746 0.3 0.2 – 0.4 36 9903 0.4 … Thromboembolism
(VTE)
14 3719 0.4 0.2 –
0.6
55 21670 0.3 0.2 –
0.3
Deep vein
thrombosis … Thromboembolism
(VTE)
40 13754 0.3 0.2 –
0.4
29 11635 0.3 0.2 – 0.4
Deep vein
thrombosis
-
www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/quality-measures/qsrs/qsrs-2021-2022-adverse-event-data-report-oct-rev.pdf
January 01, 2022 - Venous
Thromboembolism (VTE)
Deep vein thrombosis (DVT) without pulmonary
embolism (PE)
PE without … Thromboembolism
(VTE)
7 3373 0.2 0.1 –
0.4
58 18276 0.3 0.3 –
0.4
Deep vein thrombosis
( … At Risk
AE
Rate
(%) 95% CI
Venous
Thromboembolism
(VTE)
29 11746 0.3 0.2 – 0.4 36 9903 0.4 … Thromboembolism
(VTE)
14 3719 0.4 0.2 –
0.6
55 21670 0.3 0.2 –
0.3
Deep vein
thrombosis … Thromboembolism
(VTE)
40 13754 0.3 0.2 –
0.4
29 11635 0.3 0.2 – 0.4
Deep vein
thrombosis
-
www.ahrq.gov/hai/pfp/hacrate2011-12.html
January 01, 2018 - 82,000
2.51
VAP
MPSMS
Ventilator-Associated Pneumonia
35,000
1.07
34,000
1.02
VTE
-
www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa-2/124-cusp-science-safety-fg.docx
April 01, 2025 - He assessed the patient for her venous thromboembolism (VTE) risk and followed the VTE risk protocol, … this scenario: at an All-Staff meeting, a senior executive tells staff to review a checklist about VTE
-
www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/surgery/57-senior-executives-facilitator.docx
June 01, 2023 - patients, leading to reduced length of stay and fewer adverse events such as surgical site infections, venous … thromboembolism (VTE), and catheter-associated urinary tract infection (CAUTI).1
Use of multimodal
-
www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/surgery/6-gap-analysis-goal.docx
June 01, 2023 - day readmission rate (post-discharge):
All-cause inpatient mortality rate:
Optional outcome measures
Venous … thromboembolism (VTE) rate:
Patient satisfaction:
Completed by:
Department/unit:
Date:
Section
-
www.ahrq.gov/hai/pfp/interimhac2013-ref.html
December 01, 2014 - Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic … Preventing hospital-acquired venous thromboembolism: a guide for effective quality improvement. … Optimizing prevention of hospital-acquired venous thromboembolism (VTE): prospective validation of a … VTE risk assessment model. … Direct medical costs of venous thromboembolism and subsequent hospital readmission rates: an administrative
-
www.ahrq.gov/hai/pfp/hacrate2013-refs.html
October 01, 2015 - Prevention of venous thromboembolism: the Seventh ACCP Conference on Antithrombotic and Thrombolytic … Kucher N, Koo S, Quiroz R, et al Electronic alerts to prevent venous thromboembolism among hospitalized … Preventing hospital-acquired venous thromboembolism: a guide for effective quality improvement. … Optimizing prevention of hospital-acquired venous thromboembolism (VTE): prospective validation of a … Direct medical costs of venous thromboembolism and subsequent hospital readmission rates: an administrative
-
www.ahrq.gov/sites/default/files/wysiwyg/npsd/data/npsd-chartbook-2020.pdf
January 01, 2020 - number (232) of CFER-H V1.2
Venous Thromboembolism reports received was deemed insufficient for any … The Venous
Thromboembolism EVENT TYPE was added in CFER-H V1.2. … This was unexpected, as pressure ulcers,
like HAIs and venous thromboembolism (VTE), result in harm … Thromboembolism (VTE)
Asymptomatic VTE (i.e., DVT and/or PE identified on screening exam or incidentally … Thromboembolism (VTE)
Other
DATA LIMITATIONS:
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/pfp/updatedhacrateinfo.pdf
June 01, 2014 - 82,000 2.51 82,000 2.51
VAP MPSMS Ventilator-Associated
Pneumonia
35,000 1.07 34,000 1.02
VTE
-
www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/highlights/ps-project-highlights-hit-hie-2025.pdf
January 01, 2025 - Massachusetts
R01 HS030221
[Grant]
Complexity, Incidence, and
Costs Related to Delayed
Diagnosis of Venous … Thromboembolism in
Urban and Rural Primary
and Urgent Care Settings
2024–2028
$500,000
Purpose … and missed VTE diagnosis in both ambulatory
and urgent care settings. … thromboembolism (VTE) and bleeding and to weigh those risks. … Key Findings/Impact: According to the final report, researchers
developed an improved venous thromboembolism
-
www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/surgery/9-senior-executives.pptx
June 01, 2023 - Include any other outcome measure rates you have data for at your institution (e.g., superficial SSI, VTE
-
www.ahrq.gov/research/findings/final-reports/ssi/ssiapk.html
April 01, 2018 - Peri-Op Insulin Administration
2
2
0
Peri-Op Proton Pump Inhibitor
1
1
0
Peri-Op VTE
-
www.ahrq.gov/research/findings/final-reports/index.html?page=5
January 01, 2024 - Patient Safety Publication Date: April 2019
Patient-centered Approach to Reducing Harm from VTE
-
www.ahrq.gov/sites/default/files/wysiwyg/action-alliance/progress-update-2024-slides.pdf
January 01, 2024 - Deterioration
Experience
A Widow’s Perspective
on Patient Safety
Our Family 2009
Charles’ HA-VTE … Patient Safety
Our Family 2009
Yogiraj Charles Bates’ Relationships and Accomplishments
Charles’ HA-VTE
-
www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/highlights/ps-project-highlights-hit-hie-rev-0724update.pdf
July 01, 2024 - Foundation
Cleveland, Ohio
R01 HS22883
[Grant]
Patient-Centered
Approach to
Reducing Harm From
VTE … Cleveland Clinic to create
tools that physicians can use to assess an individual patient’s risk of both venous … thromboembolism (VTE) and bleeding and to weigh those risks. … Key Findings/Impact: Investigators indicated that they could create a risk
prediction model for VTE … Their decision analytic
model identified a threshold for prophylaxis based on VTE risk.
-
www.ahrq.gov/sites/default/files/wysiwyg/npsd/data/npsd-chartbook-2021.pdf
January 01, 2021 - number (232) of CFER-H V1.2
Venous Thromboembolism reports received was deemed insufficient for any … The Venous
Thromboembolism EVENT TYPE was added in CFER-H V1.2. … This was unexpected, as pressure ulcers,
like HAIs and venous thromboembolism (VTE), result in harm … Thromboembolism (VTE)
Asymptomatic VTE (i.e., DVT and/or PE identified on screening exam or incidentally … Thromboembolism (VTE)
Other
DATA LIMITATIONS:
-
www.ahrq.gov/hai/pfp/haccost2017.html
November 01, 2017 - Venous Thromboembolism.
Ventilator-Associated Pneumonia. … Thromboembolism
Clostridium difficile Infections
Discussion
Limitations
… Thromboembolism
Clostridium difficile Infections
In this report, we present the findings of our … Thromboembolism (VTE)
Ventilator-Associated Pneumonia (VAP)
Clostridium difficile Infections (CDI … Venous Thromboembolism (VTE)
A deep vein thrombosis (DVT) or pulmonary embolism (PE) developing among
-
www.ahrq.gov/hai/pfp/haccost2017-appendix.html
November 01, 2017 - "[MeSH Terms]) OR ("venous thromboembolism/economics"[MeSH Terms]) OR ("venous thrombosis/economics"[ … Venous thromboembolism after thoracic/thoracolumbar spinal fusion. … Costs of venous thromboembolism, catheter-associated urinary tract infection, and pressure ulcer. … Venous thromboembolism after major cancer surgery: temporal trends and patterns of care. … Liver cirrhosis is associated with venous thromboembolism among hospitalized patients in a nationwide
-
www.ahrq.gov/sites/default/files/2025-03/smith-werner-carayon-report.pdf
January 01, 2025 - , as they are
particularly vulnerable and experience patient safety issues in the domains of fall, venous … thromboembolism
(VTE), diagnostic and medication errors, and HAIs.
4.2.1. … Both Outcome VTE within 30 days of index ED visit63
Diagnostic safety UTI Process No urine culture … We did not see differences
in in repeat falls, VTE, newly prescribed fall risk-increasing drugs, or … Venous thromboembolism in patients with
acute leukemia: incidence, risk factors, and effect on survival