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Showing results for "culture of safety".

9361. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/39191/psn-pdf
      February 08, 2011 - standards for health care organizations and explains topics including leadership structure, hospital culture … leadership-healthcare-organizations-guide-joint-commission-leadership-standards https://psnet.ahrq.gov/issue/leadership-committed-safety

9362. PowerPoint Presentation (ppt file)
      psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.434_slideshow.ppt
      February 01, 2018 - associated impact on medical errors and patient safety Describe the role of closed-loop communication … events involve handoff (sometimes called handover) failures Improving handoff quality is a patient safety … 2014;21:154-162. https://www.ncbi.nlm.nih.gov/pubmed/23703824 12 Handoff Bundle Other major patient safety … of a resident handoff bundle. … handoffs A structured observation program Faculty development program to teach I-PASS A process and culture

9363. Using Human Factors Engineering to Improve Patient Safety, Second edition. | PSNet
      psnet.ahrq.gov/issue/using-human-factors-engineering-improve-patient-safety-second-edition
      May 18, 2016 - May 18, 2016 Improving Communication During Transitions of Care. … Root Cause Analysis in Health Care: A Joint Commission Guide to Analysis and Corrective Action of … October 23, 2013 Effect of noise on auditory processing in the operating room. … July 31, 2012 The Impact of Light on Outcomes in Healthcare Settings. … December 14, 2010 Ounce of prevention: to reduce errors, hospitals prescribe innovative

9364. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/33710/psn-pdf
      May 01, 2011 - RW: So did the shift in the patient safety field, emphasizing the role of systems, make it easier for … That can be comforting, but I think that individual attitudes and beliefs have lagged a good deal behind … I assume there's some piece of this that relates to the overall culture of the institution and how it … Those people undergo a detailed training program in patient safety, counseling, the idea of the second … AW: Nancy Berlinger and I wrote a piece about apology and how, in Western culture, apology may be the

9365. Sepsis Smart. | PSNet
      psnet.ahrq.gov/issue/sepsis-smart
      May 03, 2023 - Delayed diagnosis of sepsis  is a primary patient safety concern. … This campaign raises awareness of the symptoms of sepsis to engage patients in timely diagnosis and safe … treatment of the condition.  … of the New York City Health and Hospitals Corporation. … November 11, 2009 MedlinePlus: Patient Safety.

9366. Patients as Partners: How to Involve Patients and Families in Their Own Care. | PSNet
      psnet.ahrq.gov/issue/patients-partners-how-involve-patients-and-families-their-own-care
      July 12, 2006 - Root Cause Analysis in Health Care: A Joint Commission Guide to Analysis and Corrective Action of … April 24, 2007 The Value of Close Calls in Improving Patient Safety. … May 18, 2016 Improving Communication During Transitions of Care. … May 28, 2014 The Role of Hospitalists in Patient Safety. … and Quality April 26, 2023 Unleash the power of patients to make care safer

9367. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/836892/psn-pdf
      April 07, 2022 - mortality.13,14 Boarding critical patients in the ED also stresses the ED system which can impact safety … Innovation Patient Safety Focus This patient safety innovation addresses the problem of longer ICU stays … Reviewing the evidence base for existing patient care pathways Discussing how to change the ED-focused culture … staff to a culture of emergency critical care provision, knowledge acquisition, skill development and … Maintain a patient-focused culture. Emphasize collaboration, agility, and innovation.

9368. Thin Air | PSNet
      psnet.ahrq.gov/web-mm/thin-air
      March 01, 2006 - In addition to avoiding a culture of blame and striving to identify root causes, the solutions offered … However, this safety net is incomplete. … Fortunately, I noticed the gray color (color-coding is another safety feature) of the tank. … June 16, 2011 How does patient safety culture in the operating room and post-anesthesia … interprofessional team: a positive-exemplar case study of a new patient safety tool.

9369. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/46834/psn-pdf
      April 11, 2018 - This book discusses biases and cultural limitations that influence the safety of women's health care … Systemic problems are highlighted, such as lack of respect for patient concerns and insufficient biomedical

9370. Around the Block | PSNet
      psnet.ahrq.gov/web-mm/around-block
      March 04, 2020 - As DVT prevention is one of the top safety priorities of the Agency for Healthcare Research and Quality … patient safety issue, the American Society of Regional Anesthesia and Pain Medicine (ASRA) convened … safety and quality culture--a scoping review. … April 24, 2024 Authentic leadership at the Cleveland Clinic: psychological safety in … November 15, 2023 Safety culture and workforce well-being associations with Positive

9371. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49869/psn-pdf
      July 02, 2019 - California Maternal Quality Care Collaborative (CMQCC) (3) and the National Partnership for Maternal Safety … National Partnership for Maternal Safety: consensus bundle on obstetric hemorrhage. … National Partnership for Maternal Safety Obstetric Hemorrhage Safety Bundle.(4) https://psnet.ahrq.gov … Obstetric Hemorrhage Safety Bundle.(4) Event Opportunity NPMS Bundle Category Anterior placenta previa … A culture of huddles and debriefs encourages a culture of safety and improves situational awareness

9372. A Costly Colonoscopy Leads to a Delay in Diagnosis | PSNet
      psnet.ahrq.gov/web-mm/costly-colonoscopy-leads-delay-diagnosis
      September 01, 2014 - In a world in which financial harm represents a serious patient safety issue, physicians can no longer … health care systems should address this problem systematically, just as they do with other patient safety … Financial barriers represent a patient safety issue that can lead to many downstream consequences including … September 29, 2017 Development of a high-value care culture survey: a modified Delphi … a Positive Blood Culture July 1, 2017 Communicating findings of delayed diagnostic

9373. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49629/psn-pdf
      June 01, 2011 - Communication & Safety: The Joint Commission's Efforts Communication failure continues to be one of … Gaining buy-in and successfully implementing read-backs is also easier when there is an organizational culture … that places patient safety as a core value of the highest order. … Improving patient safety by repeating (read-back) telephone reports of critical information. … Handbook of Human Factors and Ergonomics in Health Care and Patient Safety.

9374. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/33820/psn-pdf
      December 01, 2016 - Bagian is Director of the Center for Healthcare Engineering and Patient Safety at the University of … of the VA National Center for Patient Safety from 1999–2010. … to preserve the nonpunitive nature of the safety system. … RW: My own bias is I think the culture is pretty good in terms of the blame and nonblame in the system … Really, part of this is culture. RW: Yeah, and leadership. JB: And leadership.

9375. Sentinel Event Alert. | PSNet
      psnet.ahrq.gov/issue/sentinel-event-alert
      May 30, 2012 - event alerts to review selected incidents, determine the root causes involved, and provide a summary of … November 10, 2016 Quick Safety. … Interview In Conversation with Jessica Behrhorst about The Evolution of … Eric Thomas about Zero Harm: Striving to Reduce Preventable Harms – Point, Counterpoint, and Areas of … Root Cause Analysis in Health Care: A Joint Commission Guide to Analysis and Corrective Action of

9376. Healthcare: The Problems Are Organizational Not Clinical. | PSNet
      psnet.ahrq.gov/issue/healthcare-problems-are-organizational-not-clinical
      July 14, 2010 - July 14, 2010 Educating for Safety. … March 22, 2017 Patient Safety. … Eisenberg Patient Safety and Quality Awards. November 19, 2018 2011 John M. … Eisenberg Patient Safety and Quality Awards. … March 28, 2011 The impact of shift patterns on junior doctors' perceptions of fatigue

9377. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/37379/psn-pdf
      March 28, 2012 - identifying-modifiable-barriers-medication-error-reporting-nursing-home-setting https://psnet.ahrq.gov/issue/nursing-home-administrators-opinions-resident-safety-culture-nursing-homes

9378. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/45265/psn-pdf
      July 13, 2016 - using-coworker-observations-promote-accountability-disrespectful-and-unsafe-behaviors https://psnet.ahrq.gov/issue/professionalism-necessary-ingredient-culture-safety

9379. Measuring shared mental models in healthcare. | PSNet
      psnet.ahrq.gov/issue/measuring-shared-mental-models-healthcare
      June 30, 2019 - Shared mental models are an important element of team collaboration . … This review explores the current status of methods to assess shared mental models. … August 20, 2018 How to mitigate the effects of cognitive biases during patient safety … from patient safety event reports. … August 17, 2016 Patient Safety Tools: Improving Safety at the Point of Care.

9380. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49819/psn-pdf
      February 01, 2018 - errors and patient safety. … successes that had implemented a bundle of complementary interventions to tackle complex patient safety … to teach faculty supervisors the I-PASS Method and to do assessment observations; A process- and culture-change … Because handoff processes become entrenched in institutional culture, efforts to improve them require … Hospital Boston Director, Sleep and Patient Safety Program, Sleep Medicine, Departments of Medicine