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  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49436/psn-pdf
    February 26, 2004 - Transfusion "Slip" February 1, 2004 Kaplan HS. Transfusion "Slip". PSNet [internet]. 2004. https://psnet.ahrq.gov/web-mm/transfusion-slip The Case A married couple, Mr. and Mrs. M, was brought to the emergency department (ED) of a Level 1 trauma center after a half-ton truck that had skidded out of control struck…
  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73999/psn-pdf
    October 27, 2021 - To Dilute or Not Dilute: Drug Errors and Consequences in the Operating Room October 27, 2021 Aldwinckle R, Florendo E. To Dilute or Not Dilute: Drug Errors and Consequences in the Operating Room. PSNet [internet]. 2021. https://psnet.ahrq.gov/web-mm/dilute-or-not-dilute-drug-errors-and-consequences-operating-room …
  3. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49459/psn-pdf
    September 01, 2004 - Caution, Interrupted September 1, 2004 Wears RL. Caution, Interrupted. PSNet [internet]. 2004. https://psnet.ahrq.gov/web-mm/caution-interrupted The Case A 55-year-old man with acute myelogenous leukemia and several recent hospitalizations for fever and neutropenia presented to the emergency department (ED) with …
  4. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49401/psn-pdf
    May 01, 2003 - Suicidal Man With Gun May 1, 2003 Simon RI. Suicidal Man With Gun. PSNet [internet]. 2003. https://psnet.ahrq.gov/web-mm/suicidal-man-gun The Case The patient is a 36-year-old man who came to a psychiatry clinic for outpatient evaluation of severe depression that had persisted for nearly 2 years. On initial inter…
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/72587/psn-pdf
    December 23, 2020 - Mitigating the Risk of Intrahospital Transport for Pediatric Patients at Risk of Physiologic Instability December 23, 2020 Semkiw K, Anderson D, Natale JA. Mitigating the Risk of Intrahospital Transport for Pediatric Patients at Risk of Physiologic Instability. PSNet [internet]. 2020. https://psnet.ahrq.gov/web-mm…
  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49423/psn-pdf
    November 01, 2003 - The Missing Suction Tip November 1, 2003 Thomas EJ, Moore FA. The Missing Suction Tip. PSNet [internet]. 2003. https://psnet.ahrq.gov/web-mm/missing-suction-tip Case Objectives Identify the risk factors for retained foreign bodies. Understand methods used to prevent and identify retained foreign bodies. Apprecia…
  7. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49691/psn-pdf
    September 01, 2013 - DRESSed for Failure September 1, 2013 Abramson EL, Kaushal R. DRESSed for Failure. PSNet [internet]. 2013. https://psnet.ahrq.gov/web-mm/dressed-failure The Case A 60-year-old woman who uses a wheelchair presented to the emergency department (ED) with right hand cellulitis and an uncomplicated urinary tract infec…
  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49711/psn-pdf
    June 01, 2014 - Wandering Off the Floors: Safety and Security Risks of Patient Wandering June 1, 2014 Smith TA. Wandering Off the Floors: Safety and Security Risks of Patient Wandering. PSNet [internet]. 2014. https://psnet.ahrq.gov/web-mm/wandering-floors-safety-and-security-risks-patient-wandering Case Objectives Define patie…
  9. psnet.ahrq.gov/web-mm/benefits-vs-risks-intraosseous-vascular-access
    September 01, 2005 - Benefits vs. Risks of Intraosseous Vascular Access Citation Text: Fowler RL, Lippmann MJ. Benefits vs. Risks of Intraosseous Vascular Access. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2014. Copy Citation Format: Go…
  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33699/psn-pdf
    August 01, 2010 - Operationalizing Patient Safety at Academic Medical Centers August 1, 2010 Chakraborti C, Kahn MJ, Krane K. Operationalizing Patient Safety at Academic Medical Centers. PSNet [internet]. 2010. https://psnet.ahrq.gov/perspective/operationalizing-patient-safety-academic-medical-centers Perspective Academic medical…
  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49739/psn-pdf
    August 21, 2015 - Breathe Easy: Safe Tracheostomy Management August 21, 2015 Russell MS, Russell MD. Breathe Easy: Safe Tracheostomy Management. PSNet [internet]. 2015. https://psnet.ahrq.gov/web-mm/breathe-easy-safe-tracheostomy-management The Case A 75-year-old man was admitted to the hospital with sepsis due to multilobar pneumo…
  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49674/psn-pdf
    December 01, 2012 - Preventing PICC Complications: Whose Line Is It? December 1, 2012 Moureau N. Preventing PICC Complications: Whose Line Is It? PSNet [internet]. 2012. https://psnet.ahrq.gov/web-mm/preventing-picc-complications-whose-line-it The Case A 55-year-old woman with myasthenia gravis, hypertension, and hypothyroidism prese…
  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49625/psn-pdf
    May 01, 2011 - Pocket Syringe Swap May 1, 2011 Kulli JC. Pocket Syringe Swap. PSNet [internet]. 2011. https://psnet.ahrq.gov/web-mm/pocket-syringe-swap The Case A 58-year-old man, scheduled for aortoiliac artery bypass graft, had an epidural catheter placed for postoperative pain management. Surgery proceeded uneventfully under…
  14. cdsic.ahrq.gov/sites/default/files/2024-12/OY2_Final%20IAS%20Workgroup%20Charter.pdf
    January 01, 2024 - Implementation, Adoption, and Scaling Workgroup: Charter – Option Year 2 Implementation, Adoption, and Scaling Workgroup: Charter – Option Year 2 Agency for Healthcare Research and Quality 5600 Fishers Lane Rockville, MD 20857 www.ahrq.gov Contract No: 75Q80120D00018 Prepared by: NORC at the…
  15. www.ahrq.gov/patient-safety/settings/hospital/candor/modules/guide5/notes.html
    August 01, 2022 - Module 5: Response and Disclosure AHRQ Communication and Optimal Resolution Toolkit Facilitator Notes Say: In Module 5 of the CANDOR Toolkit, we will discuss the Response and Disclosure component of the CANDOR process. Slide 1 Say: The goal of this module is to: Define…
  16. www.ahrq.gov/sites/default/files/wysiwyg/chsp/bundled-payments_0.pdf
    January 01, 2019 - Health System Participation in Medicare Bundled Payment Models, 2016 1 Comparative Health System Performance Initiative Health System Participation in Medicare Bundled Payment Models, 2016 Data Highlight, No. 6 January 2019 Hospital participation in Medicare bundled payment models, by system membership Sy…
  17. www.ahrq.gov/sites/default/files/wysiwyg/chsp/ma-plans.pdf
    March 01, 2019 - Provider-Offered Medicare Advantage Plans Among U.S. Health Systems, 2016 1 Comparative Health System Performance Initiative Provider-Offered Medicare Advantage Plans Among U.S. Health Systems, 2016 Data Highlight, No. 7 March 2019 Systems offering a Medicare Advantage (MA) plan About 12% of systems offer …
  18. www.ahrq.gov/sites/default/files/wysiwyg/chsp/insurance-products.pdf
    January 01, 2019 - Provider-Offered Insurance Products Among U.S. Health Systems, 2016 1 Comparative Health System Performance Initiative Provider-Offered Insurance Products Among U.S. Health Systems, 2016 Data Highlight, No. 5 January 2019 Systems offering an insurance product Nearly 4 in 10 systems offer an insurance produ…
  19. digital.ahrq.gov/sites/default/files/docs/medication-without-harm-qas-07242024.pdf
    July 24, 2024 - AHRQ National Webinar on Medication Without Harm – How Digital Healthcare Tools Can Support Providers and Improve Patient Safety - Q&As …
  20. digital.ahrq.gov/ahrq-funded-projects/improving-healthcare-quality-user-centric-patient-portals
    January 01, 2023 - Improving Healthcare Quality with User-Centric Patient Portals Project Final Report ( PDF , 290.12 KB) Disclaimer Disclaimer The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views…