Results

Total Results: 4,584 records

Showing results for "event".

41. Chapter 2. ST-PRA Development | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/research/findings/final-reports/stpra/stpra2.html
    April 01, 2018 - probabilities of event combinations. … Event 660 Patient fails to notice infection during home care. … Event 642 Staff fail to protect patient effectively. … Event 450 Obese, but not diabetic, patient (30 ≤BMI <40). … Event 182 Fail to administer indicated antibiotics.

42. Chapter 3. Risk-Informed Interventions | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/research/findings/final-reports/stpra/stpra3.html
    April 01, 2018 - The targeted event(s) for the intervention. A description of the proposed intervention. … For example, assuming that the top event SSI occurs, the criticality of basic event A is the probability … that the top event is a result of basic event A. … For example, "Event 642 Fail to protect the patient effectively,"ranked as the most critical unique event … Because the targeted event is comprised of multiple, related issues, the intervention can be designed

43. Learn-From-Defects-Facilitator-Guide (doc file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/sensemaking/learn-from-defects-facilitator-guide.docx
    May 01, 2017 - Sensemaking tools supply a systematic approach to event reporting. … of “why’s” to reach the root causes of the event. … the event from reaching the patient. … did not happen—No-harm event Event did not reach the patient—Near-miss event We then ask why this consequence … The tree is an interpretation of the event.

44. Prioritization Worksheet (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/c1_combo_prioritizationworksheetinstructions.pdf
    June 05, 2016 - In column E, “Volume of Cases at Risk,” indicate the annual volume of each PSI, IQI, and/or PDI event … Column F, “Cost of Single Event,” indicates the average cost to your organization of one event. … We have not included cost estimates for a single event directly in the worksheet, as you may want to … Has your organization recently experienced negative press regarding an event? … What would this look like in the community if you had an event in your organization?

45. Generic Dashboard Data 2023 (xls file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/npsd/Generic_Dashboard_Data_2023.xlsx
    January 01, 2023 - of Event/Unsafe Condition by Event Type Gen_3 Location of Event/Unsafe Condition by Report Type … _6 Near Miss Prevention Actions within Event Types Gen_7 Extent of Harm by Event Type, Age, and … Type by Year Report Year Event Type Event Count Total Yearly Events Percent 2010 Blood or Blood Product … Gen_3 Location of Event/Unsafe Condition by Event Type Event Type Location of event/unsafe condition … Gen_5 Contributing Factors by Event Type Event Type Contributing Factor(s) for Event Event Count Total

46. Sensemaking and Learn From Defects for Perinatal Safety | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/teamwork/learn-from-defects-slides.html
    July 01, 2023 - Each person brings their experience of that event/issue to the discussion. … At the top of the tree and at the top row is the discovery event. … The discovery event addresses what happened. … Providers must also correct the factors that contribute to an event. … The attributes of medical event-reporting systems: Experience with a prototype medical event-reporting

47. Event Investigation and Analysis Guide: Appendix C | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/patient-safety/settings/hospital/candor/modules/guide4/apc.html
    August 01, 2022 - Patient Safety Resources by Setting Hospital Hospital Resources CANDOR Event … Patient Safety News and Events Education & Training Resources Event … This format helps to utilize the information found in the investigation to understand why the event occurred … Page last reviewed August 2022 Page originally created April 2016 Internet Citation: Event

48. Sensemaking and Learn from Defects for Perinatal Safety (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/sensemaking/learn-from-defects-facilitator-guide.pdf
    May 01, 2017 - Sensemaking tools supply a systematic approach to event reporting. … of “why’s” to reach the root causes of the event. … the event from reaching the patient. … Harm that did not happen—No-harm event • Event did not reach the patient—Near- Slide 13 Sensemaking … The tree is an interpretation of the event.

49. Overview of TAKEheart Training Curriculum & Resources | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/takeheart/training/index.html
    February 01, 2023 - Select to view a recording of the webinar, the slides, and an event summary .  … Select to view a recording of the webinar, the slides, and an event summary . … Select to access a recording of the webinar, slides, and the event summary of the materials . … Select to access a recording of the webinar, slides, and the event summary of the materials . … Select to access a recording of the webinar, slides, and the event summary of the materials .

50. Data Submission Dashboard (xls file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/npsd/Data_Submission_Dashboard_Data_2023.xlsx
    January 01, 2023 - tables include distributions of events and unsafe conditions reported by PSOs using Common Formats for Event … Common Formats Version DS_3 Percentage of Total Reports by Report Type DS_4 Percentage of Event … DS_5 DS_5: Percentage of Event Type by Common Formats Version Event Type Version Frequency Percentage

51. C2 Prioritization Worksheet Example (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/pdi/c2_pdi_prioritizationworksheetexample.pdf
    June 05, 2016 - Indicators Toolkit Prepared by RAND and UHC for AHRQ Tool C.1 Volume of Cases at Risk Cost of Single Event … E F G H I J K L M N O P Q R List of PDIs Own Rate National Comparator Annual volume of this event … Anticipated average cost for one case with this event The total annual cost of this event to … organization Anticipated cost to investigate/ implement new process is less than annual cost of event … established organizational goals and priorities • Regulatory • Value-based purchasing • Sentinel event

52. AHRQ Pediatric Quality Indicators Prioritization Worksheet (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/pdi/c1_pdi_prioritizationworksheet.pdf
    June 05, 2016 - Indicators Toolkit Prepared by RAND and UHC for AHRQ Tool C.1 Volume of Cases at Risk Cost of Single Event … E F G H I J K L M N O P Q R List of PDIs Own Rate National Comparator Annual volume of this event … Anticipated average cost for one case with this event The total annual cost of this event to … organization Anticipated cost to investigate/ implement new process is less than annual cost of event … established organizational goals and priorities • Regulatory • Value-based purchasing • Sentinel event

53. Best Practices for Administering SOPS® Surveys Users (Webcast): Introduction (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/sops/events/webinar/best-practices-survey-administration-webcast-intro.pdf
    January 24, 2024 - PM ET Webcast Technical Info • Audio issues • Poor Connection • Use Q&A to submit questions • Event … events.westat.com/sops ► Download presentation slides and view the agenda and speaker bios on our event … site • Event recording and slides will also be available soon at https://www.ahrq.gov/sops/events/

54. Communication and Optimal Resolution (CANDOR) Toolkit | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/patient-safety/settings/hospital/candor/modules.html
    August 01, 2022 - Organizational Buy-in and Support Module 3: Preparing for Implementation: Gap Analysis Module 4: Event … Reporting, Event Investigation and Analysis Analysis Module 5: Response and Disclosure Module 6: … Generally, the CANDOR process begins with identification of an event that involves harm. … This activates initiation of coordinated post-event processes, as depicted below and described in the … Investigate and analyze an adverse event to learn from it and prevent future adverse events.

55. Event Investigation and Analysis Guide: Appendix B | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/patient-safety/settings/hospital/candor/modules/guide4/apb.html
    August 01, 2022 - Patient Safety Resources by Setting Hospital Hospital Resources CANDOR Event … Patient Safety News and Events Education & Training Resources Event … Investigation and Analysis Guide: Appendix B Detailed Review Timeline Event Type: Individuals … Timeline of Event: March 12, 2014 (0900) RN#1 received report from ED on patient Mrs. … Page last reviewed August 2022 Page originally created April 2016 Internet Citation: Event

56. Sample Disaster Preparedness Letter to Families (doc file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/nursing-home/resources/letter-emergency-contact.docx
    May 12, 2022 - health, safety, and dignity of your loved one and are committed to protecting our residents in the event … we can contact during an emergency to share our plans for sheltering in place or evacuation in the event … We would discuss this option further with you while we prepare for such an event. … Please complete the information below for our records so we know how best to proceed in the event of

57. Hospital Survey on Patient Safety (doc file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/sops/quality-patient-safety/patientsafetyculture/hospitalscanform.doc
    June 09, 2016 - Instructions This survey asks for your opinions about patient safety issues, medical error, and event … · An “event” is defined as any type of error, mistake, incident, accident, or deviation, regardless … When an event is reported, it feels like the person is being written up, not the problem (1 (2 (3 … No event reports ( d. 6 to 10 event reports ( b. 1 to 2 event reports ( e. 11 to 20 event reports … ( c. 3 to 5 event reports ( f. 21 event reports or more SECTION H: Background Information This

58. Hospital Survey on Patient Safety (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/sops/quality-patient-safety/patientsafetyculture/hospitalscanform.pdf
    December 22, 2017 - • An “event” is defined as any type of error, mistake, incident, accident, or deviation, regardless … When an event is reported, it feels like the person is being written up, not the problem ......... … We are given feedback about changes put into place based on event reports ......................... … No event reports  d. 6 to 10 event reports  b. 1 to 2 event reports  e. 11 to 20 event reports  … c. 3 to 5 event reports  f. 21 event reports or more SECTION H: Background Information This information

59. Hospital Survey on Patient Safety (pdf file)
    www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patientsafetyculture/hospital/resources/hospscanform.pdf
    March 22, 2017 - • An “event” is defined as any type of error, mistake, incident, accident, or deviation, regardless … When an event is reported, it feels like the person is being written up, not the problem ......... … We are given feedback about changes put into place based on event reports ......................... … No event reports  d. 6 to 10 event reports  b. 1 to 2 event reports  e. 11 to 20 event reports  … c. 3 to 5 event reports  f. 21 event reports or more SECTION H: Background Information This information

60. Patient and Family Engagement | Agency for Healthcare Research and Quality
    www.qualitymeasures.ahrq.gov/hai/cusp/modules/patient-family-engagement/notes.html
    September 01, 2013 - Immediate Response to an Adverse Event 4 Slide 24. … How to Communicate About an Adverse Event 6 Slide 26. … What if an Adverse Event Occurs on the Unit? … event, and the care provided as a result of the event … of emotions when an adverse event occurs.