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81. Federal Interagency Workgroup: Improving Diagnostic Safety and Quality in Healthcare (pdf file)
    ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/topics/dx-safety-workgroup-meeting-notes-mar2023.pdf
    July 14, 2023 - Federal Interagency Workgroup: Improving Diagnostic Safety and Quality in Healthcare Federal Interagency Workgroup: Improving Diagnostic Safety and Quality in Healthcare March Meeting Summary Workgroup Goal: Established in response to Senate Report 115-150. The Senate Committee on Appropriations requested “AHRQ t…

82. Federal Interagency Workgroup: Improving Diagnostic Safety and Quality in Healthcare (pdf file)
    ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/topics/dagnostic-safety-workgroupmeeting-notes-july2022.pdf
    November 03, 2022 - • Diagnostic Error in Medicine (DEM) Conference o AHRQ will be presenting on the 4 resources from

83. Resources | Agency for Healthcare Research and Quality
    ahrqpubs.ahrq.gov/questions/resources/index.html
    November 01, 2020 - 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 …

84. Peer Review: Study Section Descriptions | Agency for Healthcare Research and Quality
    ahrqpubs.ahrq.gov/funding/process/study-section/peerdesc.html
    July 01, 2017 - 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 …

85. Module 1: Using the Comprehensive Long-Term Care Safety Modules: Applying Safety Principles | Agency for Healthcare Research and Quality
    ahrqpubs.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/long-term-modules/module1/mod1-slides.html
    March 01, 2017 - Slide 18: Understanding Risk and Human Behavior 1 Human Error: Inadvertently completing the wrong … Slide 19: Managing Error and Risk 1 Human Error At-Risk Behavior Reckless Behavior

86. Improving Your Laboratory Testing Process Toolkit (pdf file)
    ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/lab-testiing/lab-testing-toolkit.pdf
    December 01, 2017 - primary care offices consistently show that the process for managing tests is a significant source of error … Some of the tools can help you identify error-prone aspects of your lab testing process, and others … Any of these steps can be a source of error if the office system allows it. … each step. • Circle the number that you feel most accurately describes the harm associated with the error … Design a change to reduce error in your office system by using a Planning for Improvements tool.

87. Using Digital Health Tools to Improve Patient Safety during Acute Care | Agency for Healthcare Research and Quality
    ahrqpubs.ahrq.gov/funding/grantee-profiles/grtprofile-dalal.html
    January 01, 2024 - 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 …

88. Well-Child Visits on the Rise, But Disturbing Gaps Remain for Underserved Populations | Agency for Healthcare Research and Quality
    ahrqpubs.ahrq.gov/news/newsletters/e-newsletter/828.html
    August 01, 2022 - One in 20 adults annually experiences a diagnostic error in outpatient settings.

89. New Toolkit Can Improve Post-Surgery Complications and Enhance Patient Recovery | Agency for Healthcare Research and Quality
    ahrqpubs.ahrq.gov/news/newsletters/e-newsletter/870.html
    June 01, 2023 - 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 …

90. Identifying Strategies to Improve Medication Safety at Home | Agency for Healthcare Research and Quality
    ahrqpubs.ahrq.gov/funding/grantee-profiles/grtprofile-xiao.html
    November 01, 2022 - 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 …

91. NPSD Dashboards | Agency for Healthcare Research and Quality
    ahrqpubs.ahrq.gov/npsd/data/dashboard/index.html
    October 01, 2023 - the type of device; type of device by residual harm to the patient; device defect, failure, or user error … ; device defect, failure, or user error by residual harm to the patient; type of health information technology

92. Final Progress Report: Leveraging a Social Network of Elders and Families To Improve Medication Safety at Transitions of Care (pdf file)
    ahrqpubs.ahrq.gov/sites/default/files/2024-01/quintana-report.pdf
    January 01, 2024 - The high ICC indicates that the independent coders introduced a minimal amount of measurement error, … Technology induced error and usability: the relationship between usability problems and prescription

93. TeamSTEPPS 2.0 Module 8: Change Management
    ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/teamstepps/instructor/onlinecourse/tsonlinemodule8.pptx
    March 28, 2006 - TeamSTEPPS 2.0 Module 8: Change Management Module 8: Change Management Online Master Trainer Course Welcome to the Welcome to module eight of the TeamSTEPPS 2.0 online master trainer course, Change Management: How to Achieve a Culture of Safety. This is Dr. Brigetta Craft, and I'll be guiding you through thi…

94. Biosketches | Agency for Healthcare Research and Quality
    ahrqpubs.ahrq.gov/news/events/ahrq-research-summit-diagnostic-safety-biosketches.html
    September 01, 2016 - She was a member of the IOM Committee on Diagnostic Error in Healthcare. … In 2008 he originated the Diagnostic Error in Medicine conference series, in 2011 he founded the Society … journal, DIAGNOSIS, devoted to improving the quality and safety of diagnosis and reducing diagnostic error … Haskell is president of the nonprofit patient organizations Mothers Against Medical Error and Consumers … Since the medical error death of her young son Lewis in 2000, Ms.

95. Advancing Diagnostic Equity Through Clinician Engagement, Community Partnerships, and Connected Care (pdf file)
    ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/topics/advancing-diagnostic-equity.pdf
    November 15, 2022 - About 1 in 20 US adults experience a diagnostic error in the outpatient setting annually,3 but this … marginalized patients, who face additional biases, discrimination, and structural fac- tors.4 Diagnostic error

96. Hospital Survey on Patient Safety Culture Version 2.0 (doc file)
    ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/hospital/SOPS-Hospital-Survey-2.0-English-05.18.21.docx
    June 09, 2016 - Version 2.0) Instructions This survey asks for your opinions about patient safety issues, medical error … processes of healthcare delivery. · A “patient safety event” is defined as any type of healthcare-related error

97. Hospital Survey on Patient Safety Culture Version 2.0 (pdf file)
    ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/hospital/SOPS-Hospital-Survey-2.0-5-26-2021.pdf
    January 01, 2021 - Version 2.0) Instructions This survey asks for your opinions about patient safety issues, medical error … • A “patient safety event” is defined as any type of healthcare-related error, mistake, or incident

98. Tool: Task Assistance | Agency for Healthcare Research and Quality
    ahrqpubs.ahrq.gov/teamstepps-program/curriculum/mutual/tools/task.html
    May 01, 2023 - Vulnerability to error is increased when people are under stress, are in high-risk situations, and are … which it is expected that assistance will be actively sought and offered to reduce the occurrence of error

99. Transitioning to the SOPS™ Hospital Survey Version 2.0: What’s Different and What To Expect, Part II: Appendixes (pdf file)
    ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/hospital/hsops2-pt2_transition_apx.pdf
    September 01, 2019 - Feedback and Communication About Error 68% 65% 3% Major wording change We are informed about errors … Nonpunitive Response to Error 61% 43% 18% Minor wording change In this unit, staff feel like their … The standard error for a prediction interval will be wider than the standard error for a confidence … Feedback and Communication About Error 68% 65% 3% +/- 2% [1% - 5%] Major wording change We … Nonpunitive Response to Error 61% 43% 18% +/- 7% [11% - 25%] Minor wording change In this unit

100. Module 5: Situation Monitoring
     ahrqpubs.ahrq.gov/sites/default/files/wysiwyg/teamstepps/diagnosis-improvement/module5-situation-monitoring.pptx
     January 10, 2022 - Cross‐monitoring does not mean spying on other team members; rather, it is a way to provide a safety net or an error … prevention or error interruption mechanism for the team, ensuring that mistakes or oversights are caught … have been used but was not.] 8 Slide A process of ongoing monitoring to recognize risk or unfolding error