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www.qualitymeasures.ahrq.gov/hai/tools/ambulatory-surgery/sections/implementation/training-tools/improving-fac-notes.html
May 01, 2017 - Studies
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AHRQ News Now
Events … Studies have found that communication failures are the cause of up to 80 percent of operating room adverse … events. … Use of the briefing card led to a drop in wrong-site surgeries and other adverse events. … Voicing Concerns in the Surgical Environment Is Important
Say:
Studies show that many times when adverse
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www.qualitymeasures.ahrq.gov/es/hai/universal-icu-decolonization/universal-icu-refs.html
September 01, 2013 - Studies
Blog
AHRQ Views
Newsletter
AHRQ News Now
Events … Safety and Adverse Events
1. Klevens RM, Edwards JR, Richards CL Jr, et al.
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www.qualitymeasures.ahrq.gov/hai/universal-icu-decolonization/universal-icu-refs.html
September 01, 2013 - Studies
Blog
AHRQ Views
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AHRQ News Now
Events … Safety and Adverse Events
1. Klevens RM, Edwards JR, Richards CL Jr, et al.
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www.qualitymeasures.ahrq.gov/data/apcd/backgroundrpt/discuss.html
April 01, 2017 - Studies
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AHRQ Views
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AHRQ News Now
Events … ordering of laboratory testing or imaging, outpatient visits for chronic disease, and ambulatory care for adverse … events following ambulatory surgery or hospitalization. 8 , 9
Pediatric care.
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www.qualitymeasures.ahrq.gov/patient-safety/settings/hospital/red/toolkit/postdischarge-phone.html
March 01, 2013 - Studies
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AHRQ Views
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AHRQ News Now
Events … Patients and Families
About AHRQ's Quality & Patient Safety Work
Patient Safety News and Events … Medicines
High Alert Medicines
Use the guide below to help monitor medicines with significant risk for adverse … events.
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www.qualitymeasures.ahrq.gov/sites/default/files/publications/files/workforce_executive_summary_0.pdf
October 01, 2016 - traditional “promotora,” or health promoter, roles
in the community, conducting outreach at community events … Cutting-edge innovation: Practices use screening tools such as the Adverse Childhood Events
Survey to
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/implementation/long-term-modules/module1/facilitator-notes.docx
March 01, 2017 - In addition, the toolkit can enable teams to address root causes of adverse events more effectively. … It investigates events or safety concerns, and determines an appropriate course of action with the employees
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www.qualitymeasures.ahrq.gov/patient-safety/reports/liability/pichert.html
August 01, 2017 - Studies
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AHRQ Views
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AHRQ News Now
Events … System in the Sanford Health System
Patient, Family Member, and Clinician Perceptions of Disclosure of Adverse … Transitional Care Medication Safety: Stakeholders' Perspectives
Medication Discrepancies and Potential Adverse … Drug Events During Transfer of Care from Hospital to Home
James W. … Patient complaints and adverse surgical outcomes. Am J Med Qual 2016; 31(5):415–22.
xxix.
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www.qualitymeasures.ahrq.gov/hai/universal-icu-decolonization/universal-icu-ape.html
September 01, 2013 - Studies
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AHRQ Views
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AHRQ News Now
Events … Safety and Adverse Events
Daily Chlorhexidine Bathing Patient Information
Why the special
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www.qualitymeasures.ahrq.gov/es/hai/universal-icu-decolonization/universal-icu-ape.html
September 01, 2013 - Studies
Blog
AHRQ Views
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AHRQ News Now
Events … Safety and Adverse Events
Daily Chlorhexidine Bathing Patient Information
Why the special
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/teamstepps/instructor/onlinecourse/tsonlinemodule3.pptx
December 01, 2005 - *
2010 - 2012: Ineffective communication among top 13 root causes of sentinel events reported **
* ( … JC Root Causes and Percentages for Sentinel Events (All Categories) January 1995−December 2005)
** (JC … As a patient safety officer, I covered all our sentinel events, as well as any other adverse events, … which may not have been sentinel events. … We use it in our adverse event reports.
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www.qualitymeasures.ahrq.gov/teamstepps/instructor/scenarios/icu.html
March 01, 2014 - Studies
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AHRQ Views
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AHRQ News Now
Events … Discuss how an unmanaged workload may lead to adverse outcomes for a patient.
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/nursing-home/nursing-home-workplace-safety-resources.pdf
January 01, 2023 - page provides tips to encourage staff members to report conditions that could
lead to near-misses or adverse … events.
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www.qualitymeasures.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/medicaidmgmt/mm3a.html
October 01, 2014 - Studies
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AHRQ Views
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AHRQ News Now
Events … Patients and Families
About AHRQ's Quality & Patient Safety Work
Patient Safety News and Events … √ Review potential drivers or predictors of adverse health outcomes. … currently available data to prospectively identify specific individuals who are at high-risk of having adverse
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/ambulatory-care/sinusitis-guide.docx
September 01, 2022 - 7 days also may be adequate for children, and are likely associated with less antibiotic-associated adverse … events.
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/assess-resident-RTI-slides.pptx
June 01, 2021 - Antibiotic Stewardship Team meetings
Use the Staff Safety Assessment and Learning From Antibiotic-Associated Adverse … Events forms to identify problems
Discuss problems and identify another area to improve with an intervention
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/strategy2/Strat2_Tool_6_Pres_TX_508.pdf
May 24, 2013 - Research shows patient-centered communication can
improve:
– Patient safety
• More than 70 percent of adverse … events caused by
breakdowns in communication
– Patient outcomes, including emotional health,
functioning
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/warm-handoff-slides-final508.pptx
April 12, 2018 - Miscommunication and omissions can lead to medical errors and adverse events.
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/pressure_ulcer_prevention/module1/module1_pu-whychange_slides.pptx
June 16, 2017 - understanding that even small failures in safety protocols or processes can lead to catastrophic or adverse … events if action is not taken to solve the problem. … Memo on never events, July 7, 2008.
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/warm-handoff-slides-final508.pdf
April 12, 2018 - Miscommunication and omissions can lead to medical errors and adverse events.