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ce.effectivehealthcare.ahrq.gov/patient-safety/settings/hospital/red/toolkit/postdischarge-phone.html
March 01, 2013 - Using clinical judgment, use this conversation to determine if further recommendations, teaching, or … If patient has lost care plan, offer to send a new copy of AHCP by mail or Email. … It should be on the care plan on the appointments page. … Do you need me to mail or Email you another copy of your care plan? … If no, ask: Would you like me to Email or mail a copy of your care plan to them?
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-166-fecc-figure-1-tables-1-5.pdf
January 01, 2011 - Discontinuity
•Inconsistent clinical
decision-making or
priority setting over
time
•Coverage
discontinuities … care
RCT - has a chronic health condition expected to last practices. … plan for their child
b. the caregiver participated in developing the
written shared care plan* … Clinical practice guidelines for support of the family in the patient-centered intensive care unit: American … Patient-centered plan-of-care tool for improving clinical outcomes.
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ce.effectivehealthcare.ahrq.gov/talkingquality/resources/comparative-reports/physicians.html
October 01, 2022 - Clinical quality measures are reported for asthma care, cancer screening, diabetes care, mental health … Subject: Primary and specialty care clinics
Developer: HealthPartners
Developer Type: Health plan … The cost ratings take into account the total cost of care for treating a whole person or specific conditions … , or both. … performance of over 200 medical groups who provide care to commercial HMO health plan members in California
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ce.effectivehealthcare.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/long-term-modules/module4/mod4-facguide.html
March 01, 2017 - If so, do these teams conduct Briefs to review any safety or care concerns? What does it look like? … B ackground—What is the clinical background?
A ssessment—What do I think the problem is? … The recommendations for additional labs and a revised plan of care was clearly communicated by the … to experience higher levels of satisfaction and also follow their care plan. … condition of the resident.
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/curriculum/teamstepps-module-2-slides.pptx
February 28, 2022 - List all the people (names or positions) responsible for directly or indirectly supporting the care of … Collaborating to create a care plan that they will follow (e.g., taking medications, scheduling and attending … Monitoring and reporting changes in the patient’s condition. … Apply the tools for leading teams to specific clinical scenarios.
21
Leadership
Team Leadership … strategy for sharing the plan.
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ce.effectivehealthcare.ahrq.gov/patient-safety/settings/long-term-care/resource/ontime/pruprev/menu.html
December 01, 2017 - of potential ways facility teams may choose to integrate the pressure ulcer prevention reports into clinical … The team may pilot report use in one unit initially and then implement in all units or implement more … Other
Resident Clinical, Functional, and Intervention Profile Report – 4-Week View
… Resident change in condition reviews
2. Weekly nutrition-at-risk meetings
3. … Care plan meetings
4. Weekly wound review meetings
5.
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/primary-care/tpc/tpc-profile-magill.pdf
April 01, 2015 - Transformed Primary Care: Care by Design
Transformed Primary Care: Care by Design™
Principal Investigator … : appropriate access, care teams, and
planned care. … senior
leadership allowed clinics to experiment with how to best adapt transformation principles to the clinical … summaries, use of advance directives, and medication
reconciliation) were associated with improvements in clinical … team and services, including new roles for medical assistants, care managers, and clinical
pharmacists
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/cusptoolkit/modules/patfamilyengagement/CUSP_Patient_Family_Engagement_Facilitator_Notes.docx
September 13, 2013 - best plan of action.
· Getting patients and families to like clinicians. … Why or why not? … may experience better clinical outcomes. … or avoid.
2. … plan and provides guidance on involving the patient and family members in the discharge discussion.
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/simulation/simslides-update-62819.ppt
January 30, 2006 - Simulation
Simulation
Team skills are developed through practice and feedback
Simulation allows health care … team performance
Observers should practice using the tool
Can be adopted to a particular type of care … Advisory Circular 120-35C
Line Operational Simulations
How to design simulation scenarios
Health care … specific TeamSTEPPS behaviors
Include the following information
Performance – Specifies the behavior
Condition … Inaccurate or incomplete information from EMS/rescue team
Leadership
Team leader advocates a plan
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/takeheart/training/implementing-automatic-referral-implementation-guide.pdf
March 01, 2023 - For example, a patient only receiving hospice or palliative care or one
with advanced dementia should … with a heart attack
that occurred 15 months ago,
who was recently hospitalized
for a non-cardiac condition … Patients meeting one of the
criteria for AR, but are
identified as being in
palliative care or
experiencing … identify patients with extreme dementia,
then you may choose to not exclude any patients for this condition … and feedback plan (see chapter
6).
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/Lion-Mangione-Britto.pdf
October 01, 2011 - “plan of care [that] is developed by the physician, child or
youth, and family and is shared with other … IPC5 individual-
ized plan of care. … IPC 5 individualized plan of care. … [chronic condition* OR “chronically ill” OR chronic illness* OR chronic medical condition*])
AND … co-operat* OR decision*
OR share OR shared OR sharing OR “care management” OR “care plan” OR “care
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/pressureulcertoolkit/putoolssect7.pdf
January 01, 2004 - Plan
Does the care plan for pressure ulcers address all the areas below (as they apply)? … Start a skin care plan.
C. … Start a skin care plan.
C. … o Mobility
o Nutrition
o Friction/Shear
Performs or supervises performance of care plan procedures … deteriorates (or according to
facility policy)
Documents care plan tied to identified risk
o
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/duration/chipra-156-fullreport.pdf
June 01, 2018 - • Prevalence of condition among children under age 21 and/or among pregnant
women. … • Fiscal burden of measure focus (e.g., clinical condition) on patients, families, public
and private … Prevalence of Condition Among Children or Pregnant Women; Severity of
Condition and Burden of Condition … Clinical or Other Rationale Supporting the Focus of the Measure
(optional)
Provide documentation of … Health plan*: Can compare quality of care among health plans.
-
ce.effectivehealthcare.ahrq.gov/patient-safety/settings/hospital/red/toolkit/redtool6.html
March 01, 2013 - of your hospital's patients (e.g., patients with a specific condition or in a specific unit). … After hospital care plan (AHCP).
3. … Plan for followup of results from lab tests or studies that are pending at discharge. … or the hospital's ability to arrange posthospital care. … things to do for their condition (of those who completed a postdischarge followup phone call).
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/strategies/rapid-response/rapidresponse_facguide.pdf
May 01, 2017 - maternity care condition … In general, rapid responders should—
• possess specialized maternity care
clinical skills, knowledge … teams
Core rapid response staff typically includes a
maternity care provider (obstetrician or
midwife … This refers to all
staff caring for the patient knowing what
the patient’s plan is through briefings … • Use of transition communication
techniques to ensure a shared mental
model of plan of care and
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ce.effectivehealthcare.ahrq.gov/sites/default/files/publications/files/pocketguide.pdf
January 01, 2020 - communicating critical
information that requires immediate attention
and action concerning a patient’s condition … Background – What is the clinical
background or context? … � What is our plan of care?
� What is staff and provider’s
availability throughout the shift? … situations
Status of Patient
Patient History
Vital Signs
Medications
Physical Exam
Plan of Care
Psychosocial … Plan Still Appropriate?
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-216-fullreport.pdf
February 01, 2018 - • Prevalence of condition among children under age 21 and/or among pregnant
women. … • Severity of condition and burden of condition on children, family, and society
(unrelated to cost … • Fiscal burden of measure focus (e.g., clinical condition) on patients, families, public
and private … Health plan*: Can compare quality of care among health plans. … Clinical or Other Rationale Supporting the Focus of the Measure (optional)
Section 6.
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/NCINQTobaccoUseHelpForm.pdf
August 01, 2012 - )
• Prevalence of condition among children under age 21 or pregnant women. … )
• Fiscal burden of measure focus (e.g., clinical condition) on patients, families, public and private … plan. … CHIPRA defines a clinical quality measure as “a measurement of clinical care that is capable of
being … , including the structure of the clinical care system, the process
of care, the outcome of care, or
-
ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/preventive/chipra-0087-fullreport.pdf
October 01, 2016 - • Prevalence of condition among children under age 21 and/or among pregnant
women.
3
• Severity … of condition and burden of condition on children, family, and society
(unrelated to cost) … • Fiscal burden of measure focus (e.g., clinical condition) on patients, families, public
and private … Clinical encounters for acute care, health
maintenance visits, or sports physicals all provide opportunities … Health plan*: Can compare quality of care among health plans.
-
ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/topics/covid-19/long-covid-summit-report.pdf
February 27, 2023 - caregivers,
clinicians, and community organizations in shaping initiatives to address this complex condition … working as a result of Long
COVID, in addition to those who may be struggling at work as a result of the condition … National Research Action Plan on Long COVID, outlining a comprehensive and equitable
strategy informing … itself, challenges in getting needed care and support, not
being trusted or believed, and reliance … to sponsor research on demonstrated
ways to bring together expertise from multiple disciplines to plan