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1. TeamSTEPPS Video Debrief Guide: CUS and Teach-Back on Inpatient Medical Unit (pdf file)
   ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/video/cus-teach-back-inpatient-medical-guide.pdf
   August 31, 2023 - A concern is raised regarding the patient’s level of alertness due to medication. … At the beginning of the video, what did the nurse do to express her concern? 2. … The nurse used “CUS” words with the team to address a patient safety concern.

2. Section 1: Overview of Mutual Support Key Concepts and Tools | Agency for Healthcare Research and Quality
   ahrqpubs.ahrq.gov/teamstepps-program/curriculum/mutual/overview/index.html
   July 01, 2023 - State the concern. State the problem (real or perceived). Offer a solution. … When an initial assertive statement is ignored: It is your responsibility to assertively restate the concern … The team member being challenged must acknowledge that they heard and understood your concern. … If the response does not clarify and alleviate concern, rephrase the anticipated danger.

3. TeamSTEPPS Mutual Support Module 4
   ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/curriculum/teamstepps-module-4-slides.pptx
   February 28, 2022 - State the concern. State the problem—real or perceived. Offer a solution. … Invoked when an initial assertion is ignored… It is your responsibility to assertively restate the concern … The team member being challenged must acknowledge that they heard and understood your concern. … If the response does not clarify and alleviate concern, rephrase the anticipated danger.

4. TeamSTEPPS Fundamentals Course: Module 6. Mutual Support | Agency for Healthcare Research and Quality
   ahrqpubs.ahrq.gov/teamstepps/instructor/fundamentals/module6/igmutualsupp.html
   March 01, 2019 - It is a nonthreatening, respectful way to make sure the concern or critical information is addressed. … State the concern. State the problem—real or perceived. Offer a solution. … Possible Answers: Opening: Say the person's name to whom the concern is addressed: "Dr. … The second challenge should provide some support for your concern. … Discuss in what way the concern is related to safety.

5. NPSD Data Spotlight - Patient Safety and COVID-19: A Qualitative Analysis of Concerns During the Public Health Emergency (pdf file)
   ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/npsd/data/spotlights/spotlight-ptsafety-and-covid-19.pdf
   November 01, 2021 - • Among a sample of records analyzed, the most common description of the patient safety concern, … Given that no specific patient safety concern was identified in the free text for these reports, the … There is no evidence in these reports that any other type of patient safety concern occurred. … The second most common type of patient safety concern identified in the data was related to a COVID- … In total, approximately two-thirds of the records analyzed identified a patient safety concern due to

6. Tool: Advocacy and Assertion | Agency for Healthcare Research and Quality
   ahrqpubs.ahrq.gov/teamstepps-program/curriculum/mutual/tools/advocacy.html
   June 01, 2023 - Assertive statements are nonthreatening, respectful ways to make sure the concern or critical information … State the concern. State the problem—real or perceived. Offer a solution. … State the concern: "I am concerned that what you said and how you said it sounded rude."

7. Tool: Two-Challenge Rule | Agency for Healthcare Research and Quality
   ahrqpubs.ahrq.gov/teamstepps-program/curriculum/mutual/tools/rule.html
   May 01, 2023 - colleagues if they have requested clarification but the response or confirmation does not ease the concern … teamwork culture where team members respectfully challenge one another when the plan is unclear or of concern … initial assertion is ignored: It is your responsibility as the challenger to assertively voice your concern

8. TeamSTEPPS 2.0 Module 6: Mutual Support
   ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/teamstepps/instructor/onlinecourse/tsonlinemodule6.pptx
   February 09, 2006 - Step two, state the concern. Step three, state the problem, real or perceived. … Say the person's name to whom the concern is addressed. Dr. Myers. Then state the concern. … The second challenge should provide some support for your concern. … To use CUS, first state your concern, then state why you're uncomfortable. … Discuss in what way the concern is related to safety.

9. TeamSTEPPS Teamwork Perceptions Questionnaire (T-TPQ) (pdf file)
   ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/instructor/reference/teampercept.pdf
   March 21, 2014 - When staff have a concern about patient safety, they challenge others until they are sure the concern

10. Tool: CUS | Agency for Healthcare Research and Quality
    ahrqpubs.ahrq.gov/teamstepps-program/curriculum/mutual/tools/cus.html
    May 01, 2023 - To use CUS, proceed as follows: C: First, state your concern . … Discuss in what way the concern is related to safety.

11. TeamSTEPPS Teamwork Perceptions Questionnaire (pdf file)
    ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/tools/ts-tpq-questionnaire.pdf
    May 31, 2023 - When staff have a concern about patient safety, they challenge others until they are sure the concern

12. TeamSTEPPS Video Debrief Guide: CUS and SBAR in Rural Community Clinic (pdf file)
    ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/video/cus-sbar-rural-clinic-guide.pdf
    August 30, 2023 - The clerk uses the key words in CUS to: • Emphasize concern. • Communicate being uncomfortable.

13. TeamSTEPPS Specialty Scenarios: Neonatal ICU (pdf file)
    ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/instructor/scenarios/neonatalicu.pdf
    March 19, 2014 - Two hours later, the nurse contacts the resident and again expresses her concern that the baby “just … At approximately 0530, the nurse calls the resident again, with another update and continued concern

14. TeamSTEPPS Pocket Guide (pdf file)
    ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/teamstepps-pocket-guide.pdf
    May 01, 2023 - y State the concern. y State the problem (real or perceived). y Offer a solution. … an initial assertive statement is ignored: y It is your responsibility to assertively restate the concern … y The team member being challenged must acknowledge that they heard and understood your concern. … y If the response does not clarify and alleviate concern, rephrase the anticipated danger.

15. Pocket Guide: TeamSTEPPS: Strategies & Tools to Enhance Performance and Patient Safety (pdf file)
    ahrqpubs.ahrq.gov/sites/default/files/publications/files/pocketguide.pdf
    January 01, 2020 - decisionmaker Assert a corrective action in a firm and respectful manner • Make an opening • State the concern … When an initial assertive statement is ignored: • It is your responsibility to assertively voice concern … times to ensure that it has been heard • The team member being challenged must acknowledge that concern

16. Tool: STEP | Agency for Healthcare Research and Quality
    ahrqpubs.ahrq.gov/teamstepps-program/curriculum/situation/tools/step.html
    June 01, 2023 - Progress: The respiratory therapist notifies the oncoming nurse of their concern.  … Even though the patient’s vital signs were normal, were there reasons for concern?  

17. Discussing Infectious Concerns About Residents With Family Members and Caregivers | Agency for Healthcare Research and Quality
    ahrqpubs.ahrq.gov/antibiotic-use/long-term-care/improve/discuss-family.html
    June 01, 2021 - Skip to main content An official website of the Department of Health and Human Services Careers Contact Us Español FAQs Search all AHRQ sites Search small Search Menu …

18. 26-Patient-Education-Guide (doc file)
    ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/hai/tools/surgery/26-patient-education-guide.docx
    June 01, 2023 - Another area of concern is pain medication.

19. AHRQ Safety Program for Perinatal Care: Labor and Delivery Unit Safety Umbilical Cord Prolapse (doc file)
    ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/strategies/labor-delivery-unit/tool_cord-prolapse.docx
    May 01, 2017 - This approach can include— · staff who identify a possible prolapse and clearly state the concern · … · Staff call out concern for or diagnosis of cord prolapse, reducing error through an anticipated and … This is a safety issue.” · Use the "two-challenge" rule, repeating concern, and asking whether you have

20. TeamSTEPPS Learning Benchmarks (pdf file)
    ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/tools/ts-learning-benchmarks.pdf
    May 31, 2023 - Stop action, verify the correct dose, and thank the nurse for her concern regarding patient safety. … Respect for team input • Focus on the patient and safety 7 D • Proper response to the question and concern