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Search results for "Hospitals"
- Web Resource
Web Resource > Multi-use Website
Texas Medical Institute of Technology.
Safetyleaders.org is a knowledge management system provided to hospital leaders and performance experts. Portions of the site are not accessible to individuals whose organizations are not actively involved in a collaborative project with the Texas Medical Institute of Technology, but the open-source material is valuable.
Web Resource > Multi-use Website
Oakbrook Terrace, IL: Joint Commission.
This 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, infection prevention. Each topical package includes infographics, videos, instruction guides, and a podcast.
Tools/Toolkit > Government Resource
VA National Center for Patient Safety.
These materials provide an introduction to the purpose of healthcare failure mode and effect analysis (HFMEA), the steps of the HFMEA process, and how to apply the technique to address the Joint Commission proactive risk assessment standard.
US Government Accountability Office. Washington, DC: US Government Accountability Office; 2004. Publication GAO-05-83.
The Government Accountability Office studied patient safety programs at four Department of Veterans Affairs (VA) health facilities and recommends that the VA emphasize leadership action and open communication to support safety improvement.
Web Resource > Database/Directory
Healthcare Cost and Utilization Project (HCUP).
This interactive tool identifies, tracks, analyzes, and compares statistics on hospital care. It is part of the Healthcare Cost and Utilization Project (HCUP). With HCUPnet, users gain easy access to all national and selected state statistics about hospital admissions. These statistics can provide insight into quality of care issues.
Kruzikas DT, Jiang HJ, Remus D, Barrett ML, Coffey RM, Andrews RA. Rockville, MD: Agency for Healthcare Research and Quality; September, 2004. AHRQ Publication No. 04-0056.
This Fact Book examines a critical area of health care quality: potentially preventable hospitalizations. Higher rates of "preventable hospitalizations" may identify areas for improvement within primary and preventive care.
Training of Hospital Staff To Respond to a Mass Casualty Incident. Summary, Evidence Report/Technology Assessment.
Hsu EB, Jenckes MW, Catlett CL, et al. Summary, Evidence Report/Technology Assessment: Number 95. Rockville, MD: Agency for Healthcare Research and Quality; April 2004. AHRQ Publication Number 04-E015-1.
This report focuses on the effectiveness of hospital disaster drills, computer simulations, and tabletop or similar exercises in training hospital staff to respond to a mass casualty incident (MCI).
Committee on the Work Environment for Nurses and Patient Safety, Board on Health Care Services, Page A, ed. Washington, DC: National Academies Press; 2004.
This AHRQ-funded Institute of Medicine study identifies solutions to problems in hospital, nursing home, and other health care organization work environments that threaten patient safety in nursing care. The report provides a blueprint of actions for all health care organizations that rely on nurses. The report's findings and recommendations address the related issues of management practices, workforce capability, work design, and organizational safety culture.
Legislation/Regulation > Multi-use Website
The Joint Commission.
According to an AHRQ-supported study, wrong-site surgery occurred at a rate of approximately 1 per 113,000 operations between 1985 and 2004. In July 2004, The Joint Commission enacted a Universal Protocol that was developed through expert consensus on principles and steps for preventing wrong-site, wrong-procedure, and wrong-person surgery. The Universal Protocol applies to all accredited hospitals, ambulatory care, and office-based surgery facilities. The protocol requires performing a time out prior to beginning surgery, a practice that has been shown to improve teamwork and decrease the overall risk of wrong-site surgery. This Web site includes a number of resources and facts related to the Universal Protocol. Wrong-site, wrong-procedure, and wrong-patient errors are all now considered never events by the National Quality Forum and sentinel events by The Joint Commission. The Centers for Medicare and Medicaid Services have not reimbursed for any costs associated with these surgical errors since 2009.
Web Resource > Multi-use Website
University of Michigan Health System, 1500 E. Medical Center Dr., Ann Arbor, MI 48109. Phone: (734) 936-4000.
The University of Michigan's Patient Safety Enhancement Program (PSEP) aims to improve the quality of patient care by conducting research that focuses on methods to prevent adverse patient outcomes.
Web Resource > Course Material/Curriculum
Denver, CO: Association of Perioperative Registered Nurses.
This free, online course provides information to practitioners about medical errors and adverse events in perioperative settings.
Shojania KG, Duncan BW, McDonald KM, Wachter RM, eds. Rockville, MD: Agency for Healthcare Research and Quality; 2001. AHRQ Publication No. 01-E058.
Most evidence reports are placed on shelves and gather dust. This one, which reviewed the state of the evidence behind nearly 80 different safety practices (including computerized order entry, use of pharmacists on rounds, methods to prevent falls and nosocomial infections, and interventions to create a culture of safety), became quite influential, in part because it was the first effort to subject safety practices to the same scrutiny as other clinical practices in terms of their evidence of effectiveness. Nearly 100,000 copies of the report have been obtained from the Agency for Healthcare Research and Quality, and its now-famous list of the top 11 practices became the focus of many a new patient safety program at hospitals around the nation. The report served as one of the intellectual underpinnings of subsequent rankings of practices such as those by the National Quality Forum and the Leapfrog Group. It also engendered a spirited debate between those who advocated a practical approach to the adoption of safety practices and those promoting a more evidence-based approach. Readers are cautioned that evidence reports have limited shelf-lives, and it is worth reviewing recent literature before adopting even the most highly rated practices in this report.
Research in Action, Issue 1. Rockville, MD: Agency for Healthcare Research and Quality; 2001. AHRQ Publication 01-0020.
Adverse drug events (ADEs) result in more than 770,000 annual injuries and deaths with significant resulting costs. Hospitals can reduce this burden by promoting system changes to better detect and prevent ADEs. Successful approaches are summarized.