AHRQ Releases June Web M&M

June 10, 2015    |   By: Calevir

The Agency for Healthcare Research and Quality (AHRQ) has released the latest issue of the Web Morbidity and Mortality Rounds on the Web (WebM&M).  Cases include Anchoring Bias with Critical Implications, Inflicting Confusion, and Unseen Perils of Urinary Catheters.

Interviews included feedback from leaders in organizations working to improve quality and safety:

  • Maureen Bisognamo, President and CEO of the Institute for Healthcare Improvement (IHI), speaks about their efforts to improve healthcare on a global level.
  • Christine Cassel, MD, President and CEO of the National Quality Forum (NQF), speaks about their work in developing and utilizing quality measures to improve safety in healthcare.

Earn CME/CEU Credits:  Take AHRQ’s online quizzes and earn CME/CEU credits. Register Now/Learn More

Submit a Case:  Do you know of a case that highlights medical errors?  All submissions are anonymous. Submit a Case/Learn More


PSO Case Law: Ungurian v. Beyzman, et al., 2020 PA Super 105:

A recent Pennsylvania case shows how courts narrowly interpret the PSQIA, ignoring the D & A pathway and the clear language of the Final Rule. (Ungurian v. Beyzman, et al., 2020 PA Super 105). The cour

Joint Commission New Sentinel Event Alert 61: Managing the Risks of Direct Oral Anticoagulants:

The Center for Patient Safety wants to share this important harm-prevention advice from The Joint Commission and its Sentinel Event Alert: Managing the Risks of Direct Oral Anticoagulants. The Joint Commis

CPS Safety Watch/Alert – Culture Can Improve the Control of Multi-Drug Resistant Organisms:

Issue: A number of events reported co CPS’ Patient Safety Organization (PSO) demonstrate poor handoff communication about the patients’ infectious disease status Examples include: Patient with

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