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The PSNet Collection: All Content

The AHRQ PSNet Collection comprises an extensive selection of resources relevant to the patient safety community. These resources come in a variety of formats, including literature, research, tools, and Web sites. Resources are identified using the National Library of Medicine’s Medline database, various news and content aggregators, and the expertise of the AHRQ PSNet editorial and technical teams.

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Displaying 1 - 20 of 91 Results
Joint Commission.
The Speak Up campaign provides sets of materials to enable patients and families to engage in making their health care experiences as safe as possible. Topics covered include safe surgery, pain management, medication safety, and most recently, how preventive care helps to keep patients healthy and out of the hospital. Each topical package includes infographics, videos, and distribution guidance. Some written materials are available in Spanish.
Joint Commission, National Quality Forum.
The Eisenberg Award honors individuals and organizations who have made key contributions to patient safety and quality improvement. The awards are presented at the National Quality Forum's annual policy conference in Washington, DC. This website provides information on all the recipients and the application process. The 2023 award submission cycle is open through August 21, 2023. 
Oakbrook Terrace, IL: Joint Commission. 2002-2023.
A series of patient safety brochures, videos and infographics directed toward specific areas of care that encourages patients to take an active role by asking questions and addressing problems with their providers. Topics include preventing falls, medication safety, and safe surgery. Available in both English and Spanish.
Joint Commission.
… This website provides sentinel event data reported to The Joint Commission, which includes information on sentinel events … with event type by year from 2018 through 2022. … Joint Commission. … Joint Commission

Oakbrook Terrace, IL: Joint Commission and National Quality Forum: January 23, 2023. 

The annual Eisenberg Award recognizes leaders and organizations who have made substantial contributions toward patient safety and quality improvement. The 2022 honorees are Jason S. Adelman, MD, MS, North American Partners in Anesthesia (NAPA) and Parkland Health, Dallas County, Texas. The awards were presented at the National Quality Forum's annual conference on February 20, 2023, in Washington, DC.
The Joint Commission.
The National Patient Safety Goals (NPSGs) are one of the major methods by which The Joint Commission establishes standards for ensuring patient safety in all health care settings. In order to ensure health care facilities focus on preventing major sources of patient harm, The Joint Commission regularly revises the NPSGs based on their impact, cost, and effectiveness. Major focus areas include promoting surgical safety and preventing hospital-acquired infections, medication errors, inpatient suicide, and specific clinical harms such as falls and pressure ulcers. The 2023 goals, which include a goal to improve health equity, are now available.
Ibrahim SA, Reynolds KA, Poon E, et al. BMJ. 2022;377:e063064.
Accreditation programs such as The Joint Commission are intended to improve patient safety and quality. Investigators evaluated the evidence base for 20 actionable standards issued by The Joint Commission. Standards were classified by the extent to which they were supported by evidence, evidence quality ratings, and the strength of the recommendation.

Oakbrook Terrace, IL: Joint Commission: April 19, 2022.

The Eisenberg Award recognizes individual and organizational accomplishment toward patient safety and quality improvement. The 2021 honorees are Hardeep Singh, MD, MPH, Prime Healthcare Services, Ontario, California, Kaiser Permanente Northern California, Oakland, California, and Mark R. Chassin, MD, FACP, MPP, MPH. The awards will be presented virtually during the National Quality Forum's annual meeting in July.

Oakbrook Terrace, IL: Joint Commission: June 8, 2021.

The Eisenberg Award honors individuals and organizations who have made critical achievements toward patient safety and quality improvement. The 2020 honorees are Dr. David Gaba, Veterans Health Administration Rapid Naloxone Initiative, Washington, DC, and Northwestern Medicine Academy for Quality and Safety Improvement, Chicago IL. The awards will be presented virtually during the National Quality Forum's annual meeting in July.
In: 2021 Comprehensive Accreditation Manual for Hospitals. CAMH. Oakbrook Terrace, IL: Joint Commission; January 2021:PS1-PS46.
… Manual for Hospitals. CAMH. Oakbrook Terrace, IL: Joint Commission; January 2021:PS1-PS46. … Joint Commission
Procaccini D, Rapaport R, Petty BG, et al. Jt Comm J Qual Patient Saf. 2020;46:706-714.
… PRN orders), which led to increased compliance with Joint Commission medication management standards. The related … enhance compliance of pro re nata medication orders with Joint Commission medication management standards in a …
Oakbrook Terrace, IL: Joint Commission Resources; 2020. ISBN: 9781635851618.
Root cause analysis has been widely adopted as a strategy to investigate events, despite questions regarding its effectiveness in health care. This revised pubication provides information about updated approaches to root cause analysis with an emphasis on idenitification of causal and contributing factors. It highlights the use of failure mode and effects analays as a complementary sentinel event examination strategy that enables design of proactive and reactive improvements.
Oakbrook Terrace, IL: Joint Commission: October 2019.
… prevent the event from occurring.  … Oakbrook Terrace, IL: Joint Commission: October 2019. … Suicidal patient slips through the cracks. Oakbrook Terrace, IL: Joint Commission: October 2019 …
The Joint Commission. R3 Report. August 21, 2019;24:1-6.
Maternal safety in the United States is gaining momentum as a system-level patient safety concern. This report reviews the new Joint Commission Provision of Care, Treatment, and Services (PC) standards developed to improve the reliability of maternal care. Actions for improvement include patient risk assessment for conditions at admission and role-specific education for staff and providers who treat maternal patients regarding hemorrhage processes and procedures.