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www.innovations.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/officebasedcare/module4/4_ts_office_leading.pptx
January 01, 2006 - Were errors made or
avoided?
What went well, what
should change, what
can improve?
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www.innovations.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/chipra_1415-p009-4-ef.pdf
January 01, 2015 - ● Missing data or ambiguous information stored in a provider’s EHR could lead to calculation errors
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www.innovations.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/duration/chipra-153-section-6b.pdf
January 01, 2013 - To examine construct validity, we report Pearson correlations and absolute errors between the external … APPENDIX Vc describes the median absolute errors between Informed Coverage, Coverage PE,
Coverage PI … In the
development set, the median absolute errors between IC or CR and the ACS survey were similar … 2.69%, and 4.09% between ACS and the Continuity Ratio, with significant difference between these
errors … Of note, the median absolute errors in the “uninformed” PE and PI versus 2009 ACS
were 6.39% and 5.54%
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www.innovations.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/acute/chipra-143-section-5a-evidence-table.pdf
January 01, 2014 - Cross-Sectional Investigators developed and tested a trigger Lander L, Roberson DW,
Study tool to identify errors … A
trigger tool fails to identify
serious errors and
adverse events in
pediatric otolaryngology … Physician review identified 587
errors or AEs (553 errors and 34 AEs). … The
trigger tool identified 92 errors and AEs. … tools
and protocols to enhance the knowledge
base about safety, (2) identifying and
learning from errors
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www.innovations.ahrq.gov/news/blog/ahrqviews/ahrq-digital-healthcare.html
February 01, 2024 - looked at how human factors and technology affect safety, how electronic systems can reduce medical errors
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www.innovations.ahrq.gov/cpi/about/mission/ahrq-fy2015-conf-spending.html
January 01, 2016 - Skip to main content
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www.innovations.ahrq.gov/sites/default/files/wysiwyg/ncepcr/tools/PCMH/pcpf-module-15-presenting-data.pdf
September 01, 2015 - These mistakes can be difficult to identify but can introduce significant
errors into any patient and … Practices Reflect and Act on Data
Many if not most times, practices’ information systems contain errors … Errors mapping data
entered into an EHR to the database variables are frequent. … When this happens, it is important that
you listen carefully to their discussion of the errors that … Once you have helped the practice correct these errors and can present the corrected data again,
you
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www.innovations.ahrq.gov/patient-safety/settings/multiple/index.html
August 01, 2023 - toolkit addresses approaches to desgin tat target six areas of safety: infections, falls, medication errors
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www.innovations.ahrq.gov/funding/grantee-profiles/grtprofile-halamek.html
August 01, 2023 - Effective Healthcare Program
Healthcare Simulation Dictionary
The Contribution of Diagnostic Errors
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www.innovations.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/officebasedcare/module6/6-ts-office-support.pptx
January 20, 2006 - a decisionmaker
Failure to employ advocacy and
assertion is a primary contributor
to the clinical errors
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www.innovations.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/officebasedcare/module10/10_ts_office_measmt.pptx
January 20, 2006 - Measures
Patient outcome measures
Examples: Complication rates, infection rates, measurable medication errors
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www.innovations.ahrq.gov/sites/default/files/wysiwyg/cpi/about/profile/ahrq-profile16.pdf
May 01, 2016 - Using AHRQ’s
research and how-to tools, the U.S. health care system
prevented 1.3 million errors, saved
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www.innovations.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/sensemaking/sensemaking.pptx
May 01, 2017 - Department of Health and Human Services makes no warranties regarding errors or omissions and assumes
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www.innovations.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/officebasedcare/module3/3_ts_office_comm-ig.pptx
January 01, 2008 - 1995 and 2005, ineffective communication was identified as the root cause for 66 percent of reported errors
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www.innovations.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/instructor/fundamentals/module5/igsitmonitor.pdf
February 12, 2014 - anticipate next steps, “watch each other’s back,” and take
appropriate corrective action to prevent errors … Creating commonality of effort and purpose
Most important, shared mental models help teams avoid errors … shared mental
model, which will enable team members to anticipate, prevent, and
correct potential errors
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www.innovations.ahrq.gov/sites/default/files/wysiwyg/sops/events/webinar/hickner-development-medical-office-sops.pdf
January 01, 2011 - Using the AHRQ Medical Office Survey on Patient Safety Culture Webinar - Hickner
1
1
Development of the
AHRQ Medical Office Survey on
Patient Safety Culture
John Hickner, MD, MSc
Chairman, Family Medicine,
Cleveland Clinic
2
2
Objectives
• Describe the development of the AHRQ
Medical Office Survey on Pat…
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www.innovations.ahrq.gov/teamstepps-program/curriculum/mutual/tools/index.html
June 01, 2023 - Mutual support provides a safety net to help prevent errors, increase effectiveness, and minimize strain
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www.innovations.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/long-term-modules/module3/mod3-facguide.html
March 01, 2017 - System design
Humans are not perfect and occasionally make mistakes, either through unintentional errors … Forcing functions, checks, and redundancies are some features of systems intended to minimize errors. … Creating a culture in which staff feel safe discussing errors and concerns will allow an organization
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www.innovations.ahrq.gov/coronavirus/practice-improvement.html
July 01, 2022 - collaboration and communication, skills essential to delivering quality healthcare and avoiding medical errors
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www.innovations.ahrq.gov/patient-safety/resources/improve-discharge/index.html
July 01, 2022 - Improving Patient Safety and Team Communication Through Daily Huddles
AHRQ PSNet Primer: Medication Errors