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441. Implementation Quick Start Guide: Be Prepared to Be Engaged (pdf file)
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/beprepared_quickstartfull.pdf
     January 01, 2015 - Safe and effective communication to prevent diagnostic errors. … & Quality Healthcare; 2013. http://psqh.com/safe-and-effective- communication-to-prevent-diagnostic-errors … dx.doi.org/10.3399/bjgp15X683929 http://psqh.com/safe-and-effective-communication-to-prevent-diagnostic-errors … http://psqh.com/safe-and-effective-communication-to-prevent-diagnostic-errors Implementation Quick

442. Slide Presentation: An Introduction to Safe Transitions for Patients to New Appointments
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/ambulatory-surgery/safetransitions/safetransitions.pptx
     November 29, 2017 - By preparing and engaging patients for new ambulatory care appointments, you can potentially: Reduce errors … These gaps have the potential to cause patient harm and safety errors, including increased hospital readmissions … Patients who require appointments with other clinicians are more vulnerable to patient safety errors. … By preparing patients for new ambulatory care appointments, you can potentially: reduce errors related

443. Fallpxtool1A (doc file)
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/fallpxtoolkit/fallpxtool1a.docx
     January 01, 2004 - This requires a culture that views errors as opportunities to improve the system, not the result of … Our procedures and systems are good at preventing errors from happening 1 2 3 4 5 SECTION B: … We are informed about errors that happen in this unit 1 2 3 4 5 4. … In this unit, we discuss ways to prevent errors from happening again 1 2 3 4 5 6.

444. The Role of Patient Safety in the Device Purchasing Process (pdf file)
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol1/Johnson.pdf
     January 01, 2004 - Introduction Studies show that more problems are caused by medical device usage errors, than are the … result of device malfunctions.1 Although device users are traditionally blamed for these errors, there … is widespread evidence to indicate that a large number of device usage errors are the result of poorly … Section 7 surveyed the subject’s attitudes toward errors and error prevention. … Healthcare employee attitudes toward medical device-use errors and their prevention.

445. Implement Teamwork and Communication for Perinatal Safety: Facilitator Guide | Agency for Healthcare Research and Quality
     ce.effectivehealthcare.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/teamwork/implement-fac-guide.html
     July 01, 2023 - Describe the connection between communication and medical errors. … According to the Joint Commission, these errors are reported over 50 percent of the time and represent … Were errors made or avoided? Are resources available? … employ advocacy and assertion frequently has been identified as a major contributor to the clinical errors … Research supports the connection between communication errors and errors in patient care delivery.

446. Appendix F. Interventions (pdf file)
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/envscan-app-f.pdf
     January 01, 2015 - Diagnostic errors in primary care: lessons learned Yes Yes Strong Review of evidence of diagnostic errors … Recommendations to identify errors. … avoid medication errors in practice. … Speak Up: Help Prevent Errors in Your Care Yes Yes Strong Speak-Up! … Yes Moderate Evidence-based guidelines for how to prevent medical errors.

447. Innovative Use of Technology in Primary Care Delivery - Slide Presentation (pdf file)
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/ncepcr/webinars/innovative-use-pcr-091423.pdf
     September 14, 2023 - deviation by ~half of caregivers ► >40% dose deviation by ~quarter of caregivers • >90% of 300K annual med errors … Implementing Strategies to Prevent Home Medication Administration Errors in Children With Medical Complexity … Preventing Home Medication Administration Errors 48 Medical Complexity = Unique Vulnerability … Implementing Strategies to Prevent Home Medication Administration Errors in Children With Medical Complexity … area where they can have all this information…and that can make life simpler and cut down on human errors

448. Engage the Team and Applying CUSP in the ICU Setting Slides (doc file)
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/cusp-icu-notes.docx
     April 01, 2022 - Errors often occur because systems frequently are not designed to catch mistakes before they reach the … Standardization makes errors in the system become more apparent, which allows us to address them. … Understanding more about the science of safety helps providers recognize that most errors arise from … So, data from defects analysis can be extremely valuable in helping to identify system errors and pointing … The goal is to learn as much as possible about potential latent and active errors contributing to the

449. Measure Descriptions for Daily Early Mobility: Slide Presentation | Agency for Healthcare Research and Quality
     ce.effectivehealthcare.ahrq.gov/hai/tools/mvp/modules/technical/daily-early-mobility-slides.html
     February 01, 2017 - Slide 21: Attention Screening Exam Count the number of errors. … Inattention is present if the patient commits more than two errors. … Use only if CAM-ICU or ICDSC are not performed Enter the number of errors, 0 to 10 . … Enter " NK " if the exam was performed, but number of errors is not known.

450. Views of Emergency Medicine Trainees on Adverse Events and Negligence: Survey Results from an Emergency Medicine Training Program in a Regional Health Care System Following the National Standard of Care (pdf file)
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol2/Advances-Shah_99.pdf
     March 23, 2008 - Errors conference: Executive summary. Acad Emerg Med 2000; 7: 1180-1182. 8. … Association of perceived medical errors with resident distress and empathy. … The Institute of Medicine report on medical errors – Could it do harm? … Views of practicing physicians and the public on medical errors. … to their errors: An exploration.

451. Hospital SOPS Translation Information | Agency for Healthcare Research and Quality
     ce.effectivehealthcare.ahrq.gov/sops/international/hospital/translators.html
     October 01, 2014 - Our procedures and systems are good at preventing errors from happening. A10. … We are informed about errors that happen in this unit. C5. … In this unit, we discuss ways to prevent errors from happening again. 7. … through the hospital's event reporting system; the items are not about disclosure or reporting of errors … Nonpunitive Response to Errors ( More about this dimension: In a nonpunitive environment, when a mistake

452. New AHRQ SOPS™ Health Information Technology Patient Safety Supplemental Items for Hospitals - (Yount) (pdf file)
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/sops/quality-patient-safety/patientsafetyculture/hospital/healthitwebinar/sops-hit-webcast4-yount.pdf
     August 02, 2018 - past 3 months… “Physicians sometimes copy and paste incorrect information in notes…” “I think the errors … I notify the appropriate person of these errors.”

453. Be Prepared to Be Engaged (pdf file)
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/be-prepared_webinar_slides.pdf
     January 01, 2015 - Safe and effective communication to prevent diagnostic errors. … http://psqh.com/safe-and-effective-communication-to-prevent- diagnostic-errors. 5.

454. Hospital Administrative Staff vs. Nursing Staff Responses to the AHRQ Hospital Survey on Patient Safety Culture (pdf file)
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol2/Advances-Hannah_23.pdf
     February 24, 2008 - (AHRQ) funded, voluntary network of hospitals working to report, analyze, and learn from medical errors … This compares item A18 (non-reverse-worded), “Our procedures and systems are good at preventing errors … about changes implemented, and discuss ways to prevent errors. … Reducing errors in medicine. Br Med J 1999; 319: 136-137. 2. Brennan TA, Leape LL. … Lucian Leape on the causes and prevention of errors and adverse events in health care.

455. Engaging Patients and Families in Their Health Care | Agency for Healthcare Research and Quality
     ce.effectivehealthcare.ahrq.gov/patient-safety/patients-families/patient-family-engagement/index.html
     April 01, 2018 - This toolkit is designed to help staff actively engage patients and their care partners to prevent errors … effectiveness reviews that cover health topics suggested by the public. 20 Tips to Help Prevent Medical Errors … Other Resources Question Builder 20 Tips To Help Prevent Medical Errors Patients and Providers

456. Planning Grants Final Evaluation Report: Longitudinal Evaluation of the PSML Reform Demonstration Program (pdf file)
     ce.effectivehealthcare.ahrq.gov/sites/default/files/publications/files/psml-planning-grants-final-report.pdf
     May 01, 2016 - , were a contributing factor in 14 percent of errors in the sample. … improvements to prevent similar errors in the future” (Corbett et al., 2013). … , were a contributing factor in 14 percent of errors in the sample. … The researchers also learned through the project that the taxonomy used to classify errors could be … Improving patient safety and restructuring medical liability using ACEs: Medication errors.

457. Presentation: Program Overview
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/technical/dailycare-processes-slides.pptx
     January 01, 2017 - Safety Program for Mechanically Ventilated Patients 28 Attention Screening Exam Count the number of errors … Inattention is present if the patient commits more than two errors If the patient squeezes on every … Use only if CAM-ICU or ICDSC are not performed Enter the number of errors, 0 to 10 Enter “X” if the exam … if unable to assess RASS = -4 or -5 SAS = 1 or 2 Enter “NK” if the exam was performed, but number of errors

458. Slide 1
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/leveraging-cultural-change-080814.pptx
     January 01, 2013 - of safety is Reporting -- the people in direct contact with risks and hazards freely report their errors … necessary to engineer a reporting culture—an organization in which people are prepared to report their errors … knowledgeable about a process to make decisions, and resists the temptation to blame individuals for errors … to Leverage Change Example- Hospital x Greatest opportunities: Feedback & Communication About Errors

459. PowerPoint Presentation
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/medicinelist-slides-final508.pptx
     April 10, 2018 - That’s at least 160 million errors. … In the primary care setting, medication safety issues include prescribing errors, contraindications, … Results in a complete and accurate medicine list Reduces medicine errors Offers the opportunity to reduce … One clinician observed, “It closes the gaps, reduces medication errors, offers the opportunity to reduce

460. Preparing Data from CAHPS Surveys for Analysis (pdf file)
     ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/cahps/surveys-guidance/helpful-resources/analysis/preparing-data-for-analysis.pdf
     May 15, 2017 - Their results should then be compared to identify and correct data entry errors. … Finally, if you have programmed the CAHPS instrument into a Web survey, issues with skip pattern errors … • Having an original file will allow you to correct any data errors made during the cleaning process … An audit will also identify possibly coding errors. … Conducting the audit immediately after data entry allows you to catch errors before proceeding with