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www.ahrq.gov/sites/default/files/wysiwyg/evidencenow/tools-and-materials/EvidenceNOW-Webinar-Practical-Solutions.pdf
May 01, 2018 - Care
Practice Culture
• Strong commitment by leadership which embraces … external technical
assistance
• Expand opportunities for financial assistance,
particularly for safety … - Their EHR
- Custom reports
- Registries
- Chart review
1
Model of HIT use and … Initiative
One Stream of Influence
Second Stream of Influence
Third Stream of Influence
Waters … in Primary Care
Practice Culture
Health IT Tools
Knowledge and Skills
Processes and Workflows
Financial
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www.ahrq.gov/patient-safety/reports/liability/baker.html
August 01, 2017 - Advances in Patient Safety and Medical Liability
Patient, Family Member, and Clinician Perceptions … Contents
Advances in Patient Safety and Medical Liability
Preface
Acknowledgments
Prologue … Disclosure of Adverse Events in Labor and Delivery
Patient Safety Culture and Medical Liability—Recommendations … Measurement, Analysis, and Interpretation: A Commentary
Error Disclosure Training and Organizational Culture … Making patient safety the center piece of liability reform. N Engl J Med 2006; 354:2205‑8.
6.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/ambulatory-surgery/sections/sustainability/management/huddles/daily-huddles-facnotes.docx
May 01, 2017 - Finally, the system involves integration, the alignment of staff at all levels around safety goals, and … the performance of standard work across organizational levels that supports safety, with these three … This module will focus on the practice of daily safety huddles, which, as you can see, is a core, central … SAY: On this slide, we lay out the “what” and “why” for the practice of daily safety huddles. … a dedicated improvement project found a 10 percentage-point increase in its safety culture survey scores
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/preventing-cauti-engaging-clinicians-051413.ppt
January 01, 2013 - and preventing harm
Likely unaware of safety efforts in the hospital; most have limited time to volunteer … for supporting the safety agenda
Change may not be readily embraced
*
How to Engage Physicians? … Joint Comm Journal Qual Safety 2009)
*
A third approach entails enlisting a member of an appropriate … Sept 2010)
Cultivated a culture of clinical excellence
Developed a clear vision
Successfully conveyed … culture)
*
Factors that Influence Sustainability
Integration with existing programs/services (“
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www.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/teamwork/pf-engagement-slides.html
July 01, 2023 - Patient and Family Engagement for Perinatal Safety
AHRQ Safety Program for Perinatal Care
Slide … 1: AHRQ Safety Program for Perinatal Care
Patient and Family Engagement for Perinatal Safety
Slide … and how to achieve results
Are strangers in this environment
Don't understand the system or culture … Patient safety.
Perceptions of quality. … They help our hospital improve quality and safety of care by—
Giving input and feedback.
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www.ahrq.gov/hai/cusp/modules/patient-family-engagement/sl-pat-fam.html
September 01, 2013 - Comprehensive Unit-based Safety Program (CUSP) Toolkit. … and are aimed at improving patient safety. … and how to achieve results
Are strangers in this environment
Don't understand the system or culture … They help our hospital improve quality and safety of care by:
Giving input and feedback. … The Link Between Communication and Patient Safety 1
Patient outcomes.
Patient safety.
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www.ahrq.gov/sites/default/files/wysiwyg/action-alliance/implementing-cms-measure-chat-transcript.pdf
May 01, 2025 - • In this webinar, patient safety and quality improvement experts discussed the importance
of safety … In this webinar,
patient safety and quality improvement experts discussed the importance of safety … patient safety and quality improvement experts discussed the importance
of safety competency and training … Does your work help promo health and safety
of the future demographics of the general population? … I teach TeamSTEPPS and Just Culture - will continue to share the spread.
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www.ahrq.gov/practiceimprovement/delivery-initiative/casalino/index.html
December 01, 2017 - , culture, external incentives, processes, and patient engagement of a delivery system organization ( … Culture and leadership influence structure and are in turn shaped by incentives. … Incentives, structure, culture and leadership all influence clinical and delivery processes. … Slide 11
Key research area #1
Analyses of the demographics of the delivery system—i.e., of each … And of relationships among the components of the model.
Slide 12
Why?
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/technical/nursedr-early-mobility-protocols-slides.pptx
January 01, 2017 - You will be able to distinguish the AHRQ Safety Program for Surgery from that of other national improvement … The connection between surgical safety teamwork and safety culture work as structured in the Comprehensive … Unit-based Safety Program (CUSP) will be clear. … of Outcomes
Process evaluation
Percentage of patients who received the intervention of early mobility … mobility into care of critically ill patient
Use contraindications to screen patient to ensure safety
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www.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/curriculum/teamstepps-module-2-slides.pptx
June 02, 2025 - Support and encourage
staff during implementation
and culture change. … Define the culture of
the organization.
15
15
Team Structure Video
Team Leadership
16 … key events
Analysis of why the event occurred
Discussion of lessons learned and reinforcement of successes … Resolution
Team Leadership
Effective leaders:
Facilitate conflict resolution to avoid compromising patient safety … and quality of care.
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www.ahrq.gov/sites/default/files/2024-07/cox-carayon-report.pdf
January 01, 2024 - of safety. … Last, because of survey length limitations, we did not collect data on concepts such
as general beliefs … Surveys on patient safety culture. http://www.ahrq.gov/
professionals/quality-patient-safety/patientsafetyculture … Improving safety culture on adult medical units through
multidisciplinary teamwork and communication … Quality improvement initiative to reduce serious safety events
and improve patient safety culture.
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www.ahrq.gov/sites/default/files/wysiwyg/cahps/news-and-events/events/webinars/cahps-ch-hospital-webcast-122223-bakdash.pdf
June 02, 2025 - Social Science Analyst, CAHPS® & SOPS® Programs
Center for Quality Improvement & Patient Safety,
AHRQ … AHRQ’s Core Competencies
• AHRQ is a research and development agency in the US Department of Health … Improvement, and
Data & Analytics
• AHRQ is not a regulatory agency:
► AHRQ does not require use of … Encourage CAHPS database submissions for Quality Improvement
• AHRQ’s investment is in patient experience of … research, and hosting databases for selected CAHPS surveys
6
Patient Experience
7
ASPECTS
OF
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www.ahrq.gov/hai/cauti-tools/phys-championsgd/appa.html
October 01, 2015 - Teamwork and Communication Definitions and Tools
Previous Page
Table of Contents … Device-Associated Infections
Resident Physicians as Safety Champions
Sustainability
Preventing … A concise statement of the problem. … Analysis and considerations of options and risks. … and understanding, or maintain awareness to support functioning of the team.
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www.ahrq.gov/hai/tools/ambulatory-surgery/sections/sustainability/management/huddles-fac-notes.html
June 01, 2017 - Finally, the system involves integration, the alignment of staff at all levels around safety goals, and … the performance of standard work across organizational levels that supports safety, with these three … This module will focus on the practice of daily safety huddles, which, as you can see, is a core, central … Say:
On this slide, we lay out the “what” and “why” for the practice of daily safety huddles. … a dedicated improvement project found a 10 percentage-point increase in its safety culture survey scores
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/howtogetstarted/How_to_Use_Guide_508.docx
April 05, 2013 - It is a critical part of what your hospital is already doing to improve quality and safety. … safety. … To be effective, patient and family engagement must be integrated into the organizational culture. … Revealing and resolving patient safety defects: the impact of leadership walkrounds on frontline caregiver … assessments of patient safety.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Henriksen_104.pdf
January 01, 2025 - At the institutional level—hospital, group, ambulatory care
center, nursing home—we have achieved a culture … of safety. … An outside observer is struck by three characteristics that are very different from the culture of
the … o Identification of the effects and contributions to patient safety of a patient reporting
system of … for patient involvement as part of the processes of care to contribute to safety
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www.ahrq.gov/research/findings/final-reports/iomracereport/reldata6a.html
May 01, 2018 - ambulatory health care, behavioral health care, home care, and hospice care) have required that patients' culture … disease registries, birth and death vital statistics, hospital discharges, health care surveys, patient safety … state populations because of the diversity of ethnic groups in different parts of the country, states … Joint Commission Journal on Quality and Patient Safety 34(5):256-265.
Lurie, N., M. Jung, and R. … Madison, WI: Division of Public Health, Wisconsin Department of Health Services.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol2/Advances-Ballard_12.pdf
February 02, 2008 - The long-term goals for this project
include:
• Creating a culture that fosters interdisciplinary … testing, the order set is
reviewed by the BHCS Pharmacy and Therapeutics Committee and the Patient Safety … Changes are reviewed by the BHCS Pharmacy and Therapeutics
and Patient Safety Committees. … PN-3b blood culture before first antibiotic.
4. … APR DRG Risk of Mortality was
used in the models for safety and effectiveness indicators, while APR
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/howtogetstarted/Best_Practices_Hosp_Leaders_508.pdf
March 13, 2013 - safety. … patient and family
engagement for improving the safety and quality of hospital care. … data about the organization, leaders help
create a culture of transparency and improvement. … and support clinicians and hospital staff
in patient and family engagement initiatives
Creating a culture … Sanford-Ring, Susan, Director of Quality and Patient Safety at the University of
Wisconsin Hospital and
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www.ahrq.gov/sites/default/files/wysiwyg/evidencenow/tools-and-materials/evidence-now-webinar-learning-health-care-systems.pdf
August 02, 2017 - their patients, and build and
disseminate a blueprint of what works to transform care
Scope of … of implementation of
intervention
Timeline
We are
here! … et al., 2010)
AHRQ’s Interest in PFs
Integrating Chronic Care and Business Strategies in the Safety … operations
Payment reform
Engagement with community
Engaged Leadership
Leadership and Culture … Change
Shared leadership
Team approach to patient care
Culture that tolerates failure