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Showing results for "event".

21. Medication or Other Substance Dashboard | Agency for Healthcare Research and Quality
    preventiveservices.ahrq.gov/npsd/data/dashboard/medication.html
    October 01, 2023 - type of incorrect dose, type of incorrect dose by residual harm to the patient, stage of process where event … originated, and stage of process where event originated by residual harm to the patient.

22. USER GUIDE: COVID-19 Vaccination Tracking Tool for Use in Skilled Nursing Facilities (pdf file)
    preventiveservices.ahrq.gov/sites/default/files/wysiwyg/nursing-home/materials/user-guide-covid-19-vaccination-tracking-tool-nursing-facilities.pdf
    July 01, 2022 - Select Adverse Event (Reaction) to 1st Dose. … Select Adverse Event (Reaction) to 2nd Dose. … Adverse Event (Reaction) to any COVID-19 Vaccine Dose? … Select Adverse Event (Reaction) to 1st Dose. … Select Adverse Event (Reaction) to 2nd Dose.

23. Ventilator-Associated Event Surveillance: Facilitator Guide | Agency for Healthcare Research and Quality
    preventiveservices.ahrq.gov/hai/tools/mvp/modules/vae/surveillance-fac-guide.html
    February 01, 2017 - Program Tools Mechanically Ventilated Patients Toolkit Ventilator-Associated Event … Guide AHRQ Safety Program for Mechanically Ventilated Patients Slide 1: Ventilator-Associated Event … Surveillance Say: This module will focus on ventilator-associated event surveillance and how it … unit staff can spend time focusing on what went wrong and how to fix it rather than debate whether the event … 2017 Page originally created February 2017 Internet Citation: Ventilator-Associated Event

24. AHRQ Quality and Safety Review System (QSRS) | Agency for Healthcare Research and Quality
    preventiveservices.ahrq.gov/patient-safety/quality-measures/qsrs/index.html
    September 01, 2022 - Overall, the QSRS will generate adverse event rates and trend performance over time. … The QSRS also: Offers an expanded array of adverse event measures, including ones related to opioid … standardized definitions and algorithms, consistent with those used by the AHRQ Common Formats for Event … This approach ensures that an event identified at one institution is the same as one identified elsewhere

25. Nursing Home Workplace Safety Resource List (pdf file)
    preventiveservices.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/nursing-home/nursing-home-workplace-safety-resources.pdf
    January 01, 2023 - /resources/patient-safety-topics/sentinel-event/sentinel- event-alert-newsletters/sentinel-event-alert … /sentinel-event-alert-newsletters/sentinel-event-alert-59-physical-and-verbal-violence-against-health-care-workers … https://www.jointcommission.org/resources/patient-safety-topics/sentinel-event/sentinel- event-alert-newsletters … /sentinel-event-alert-60-developing-a-reporting-culture-learning-from- close-calls-and-hazardous-condi … /sentinel-event-alert-newsletters/sentinel-event-alert-60-developing-a-reporting-culture-learning-from-close-calls-and-hazardous-condi

26. Cover slide
    preventiveservices.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/cusptoolkit/modules/patfamilyengagement/CUSP-Patient-Family-Engagement.pptx
    May 01, 2013 - improve communication among patients, families, and clinicians Discuss how to communicate an adverse event … — Infrastructure advisory Engaging in everyday care — How-to strategies Engaging after an adverse event … Introduction to Adverse Events Adverse event: An injury to a patient caused by medical intervention … family Prompt, compassionate, and honest communication with the patient and family after an adverse event … the appropriate parties Communicate with the patient (who, what, when, where, and why) Document the event

27. Situation Monitoring: Obstetric Hemorrhage - PowerPoint Presentation
    preventiveservices.ahrq.gov/sites/default/files/wysiwyg/hai/tools/perinatal-care-2/hemorrhage_4-situation-monitoring.pptx
    July 01, 2023 - For instance, was there enough medication to manage a severe hypertension event? … For instance, was there enough medication to manage a severe hypertension event? … What system issues contributed to how we handled the event? … What system issues contributed to how we handled the event? … During the Response stage, you might debrief after a patient hemorrhage event.

28. Situation Monitoring: Severe Hypertension - PowerPoint Presentation
    preventiveservices.ahrq.gov/sites/default/files/wysiwyg/hai/tools/perinatal-care-2/hypertension_4-situation-monitoring.pptx
    July 01, 2023 - What system issues contributed to our handling of the event? … What teamwork behaviors contributed to our handling of the event? … What system issues contributed to our handling of the event? … What teamwork behaviors contributed to our handling of the event? … Please note that the scenario does not relate to a severe hypertension event.

29. How Does the NPSD Work? | Agency for Healthcare Research and Quality
    preventiveservices.ahrq.gov/npsd/how-does-npsd-work/index.html
    February 01, 2024 - Patient Safety Organization Privacy Protection Center (PSOPPC) using the AHRQ Common Formats for Event … The AHRQ Common Formats for Event Reporting can be used to report patient safety concerns, a term that … Presently, data must comply with AHRQ's Common Formats for Event Reporting (CFER) in order to be accepted

30. Situation Monitoring: Obstetric Hemorrhage (pdf file)
    preventiveservices.ahrq.gov/sites/default/files/wysiwyg/hai/tools/perinatal-care-2/hemorrhage_4-situation-monitoring-speaker-notes.pdf
    July 01, 2023 - For instance, was there enough medication to manage a severe hypertension event? … For instance, was there enough medication to manage a severe hypertension event? … • What system issues contributed to how we handled the event? … • What system issues contributed to how we handled the event? … During the Response stage, you might debrief after a patient hemorrhage event.

31. Module 8: Organizational Learning and Sustainability | Agency for Healthcare Research and Quality
    preventiveservices.ahrq.gov/patient-safety/settings/hospital/candor/modules/notes8.html
    August 01, 2022 - After the resolution of a CANDOR event, information is fed into an organization’s performance improvement … These may include a checklist to follow after an event. … Event Reporting, Investigation, and Analysis Team. Resolution Team. … Ask patients and family members to share their stories to put a human face on a harm event and engage … Think about a patient story involving a CANDOR event.

32. Situation Monitoring: Severe Hypertension (pdf file)
    preventiveservices.ahrq.gov/sites/default/files/wysiwyg/hai/tools/perinatal-care-2/hypertension_4-situation-monitoring-speaker-notes.pdf
    July 01, 2023 - • What system issues contributed to our handling of the event? … • What teamwork behaviors contributed to our handling of the event? … • What system issues contributed to our handling of the event? … • What teamwork behaviors contributed to our handling of the event? … Please note that the scenario does not relate to a severe hypertension event.

33. Public Reporting of Patients' Comments with Quality Measures: How Can We Make It Work? (pdf file)
    preventiveservices.ahrq.gov/sites/default/files/wysiwyg/cahps/news-and-events/events/20140603_QI/1_dale_shaller_intro.pdf
    June 03, 2014 - Click on the “Download Slides” icon for a PDF version. 10 www.cahps.ahrq.gov Accessing Event … Materials 11 To access the event materials and resources, click on the “Resources” icon. … To Ask a Question Accessing Presentations Accessing Event Materials

34. How PSOs Help Health Care Organizations Improve Patient Safety Culture (pdf file)
    preventiveservices.ahrq.gov/sites/default/files/wysiwyg/npsd/npsd-patient-safety-culture-brief.pdf
    September 01, 2016 - One way to drive improved culture is to develop the norm of routine safety event reporting. … that encourage and facilitate patient safety Program Brief Network of Patient Safety Databases event … Several PSOs provide members a confidential analysis of patient safety event data, and provide forums … PSOs encourage voluntary patient safety event reporting by offering technical assistance and the … a series of calls to walk their members through procedures for efficiently and safely submitting event

35. Patient Experience as a Source for Understanding the Origins, Impact, and Remediation of Diagnostic Errors, Volume 2: Eliciting Patient Narratives (pdf file)
    preventiveservices.ahrq.gov/sites/default/files/wysiwyg/topics/dxsafety-patient-experience-vol2.pdf
    July 01, 2023 - The Challenge: Most studies eliciting patient experience with medical errors focus on the adverse event … The focus of questions is on the immediate antecedents and outcomes of the adverse event. … is that the ways patients and clinicians interact in the aftermath of that event go unreported. … But only 14 percent more reported such an event from 2 to 5 years before the survey (less than half … Families as partners in hospital error and adverse event surveillance.

36. Medication or Other Substance Supplement Dashboard | Agency for Healthcare Research and Quality
    preventiveservices.ahrq.gov/npsd/data/dashboard/medication-supplement.html
    September 01, 2023 - includes information organized by medication events at a glance, including description of substance event … , stage event originated, and type of substance involved for incidents, near misses, and unsafe conditions

37. Diagnostic error in mental health: a review (pdf file)
    preventiveservices.ahrq.gov/sites/default/files/wysiwyg/topics/dx-safety-mental-health-bmjqs.pdf
    April 15, 2024 - Sentinel event alert. 2022. … Available: https://www.jointcommission.org/resources/sentinel-event/ sentinel-event-alert-newsletters … /sentinel-event-alert-newsletters/sentinel-event-alert-65-diagnostic-overshadowing-among-groups-experiencing-health-disparities … / https://www.jointcommission.org/resources/sentinel-event/sentinel-event-alert-newsletters/sentinel-event-alert … / https://www.jointcommission.org/resources/sentinel-event/sentinel-event-alert-newsletters/sentinel-event-alert

38. Hospital Survey on Patient Safety Culture Version 2.0 (pdf file)
    preventiveservices.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/hospital/SOPS-Hospital-Survey-2.0-5-26-2021.pdf
    January 01, 2021 - Instructions This survey asks for your opinions about patient safety issues, medical error, and event … • A “patient safety event” is defined as any type of healthcare-related error, mistake, or incident … When an event is reported in this unit, it feels like the person is being written up, not the problem … In this unit, we are informed about changes that are made based on event reports ........... … Hospital management seems interested in patient safety only after an adverse event happens .......

39. Network of Patient Safety Databases Falls Chartbook, 2023 (pdf file)
    preventiveservices.ahrq.gov/sites/default/files/wysiwyg/npsd/data/npsd-falls-chartbook-2023.pdf
    January 01, 2023 - • The NPSD is a summary of the elements in Hospital Common Formats Event Reports for specific types … • While it is believed that the Common Formats for Event Reporting-Hospitals (CFER-H) are primarily … Data and Analysis Available at the NPSD Submission of patient safety event data by providers to PSOs … Hence, the event report data submitted to the NPSD cannot be used to calculate the actual incidence … Event Types represent the distinct modules of the CFER-H (e.g., Fall).

40. Federal Interagency Workgroup: Improving Diagnostic Safety and Quality in Healthcare (pdf file)
    preventiveservices.ahrq.gov/sites/default/files/wysiwyg/topics/public-notes-meeting-summary-111921.pdf
    March 11, 2022 - Conference included sessions or posters on the following AHRQ-supported work: Common Formats for Event … Indian Health Service • Enhanced Adverse Event Reporting Capabilities: o Reporting of adverse events