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www.ahrq.gov/sites/default/files/wysiwyg/action-alliance/advance-organizational-safety-strategies-slides.pdf
June 18, 2024 - NAA National Webinar May 2024 - Understanding and Operationalizing the National Action Alliance Aim #1: Advance Organizational Safety Strategies Using National Action Plan Foundations
Understanding and Operationalizing the National Action
Alliance Aim #1: Advance Organizational
Safety Strategies Using National Act…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol3/Shaha.pdf
May 01, 2004 - Establishing a Culture of Patient Safety Through a Low-tech Approach to Reducing Medication Errors
333
Establishing a Culture of Patient
Safety Through a Low-tech Approach
to Reducing Medication Errors
Steven H. Shaha, Linda Brodsky, Michael S. Leonard, Michael A. Cimino,
Sandra A. McDougal, Joann M. Pilliod…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/modules/implementation/imp_learn_from_defects_facnotes.docx
December 01, 2017 - This team includes the team’s facilitator, champion, unit manager, provider champion, and the senior executive … The senior executive can offer organizational vision and inform about interventions that the organization
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www.ahrq.gov/sites/default/files/wysiwyg/cahps/news-and-events/events/webinars/2024-virtual-research-meeting-summary-prems-proms.pdf
January 01, 2024 - Patient-Centered Outcome Measures in Value-Based Healthcare
Elizabeth Teisberg
Elizabeth Teisberg, Ph.D., Executive … Shaller, M.P.A., Principal, Shaller Consulting Group
Moderator for Part III: Susan Edgman-Levitan, P.A., Executive
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www.ahrq.gov/diagnostic-safety/resources/issue-briefs/leadership-3.html
June 01, 2021 - Leadership To Improve Diagnosis: A Call to Action
How Can Leaders Drive Improvements in Diagnostic Safety?
Previous Page Next Page
Table of Contents
Leadership To Improve Diagnosis: A Call to Action
Diagnostic Safety as a Challenge for Healthcare Leadership
Why Are Leaders Essential to Diagnosti…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/modules/onboarding/onboarding_ssi_investigation_facnotes.docx
December 01, 2017 - Facilitator Guide: Sustaining and Spreading Surgical Safety Improvements
Performing an SSI Investigation – Facilitator Notes
Slide Title and Commentary
Slide Number and Slide
Performing an SSI Investigation
SAY:
In this module, you’ll learn about performing a surgical site infection or SSI investigation.
Slide …
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www.ahrq.gov/hai/tools/surgery/modules/on-boarding/ssi-investigation-fac-notes.html
December 01, 2017 - Performing an SSI Investigation: Facilitator Notes
AHRQ Safety Program for Surgery
Slide 1: Performing an SSI Investigation
Say:
In this module, you’ll learn about performing a surgical site infection or SSI investigation.
Slide 2: Learning Objectives
Say:
Here are the objectives.
We want to d…
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www.ahrq.gov/hai/cusp/toolkit/learn-defects.html
December 01, 2012 - Learn from Defects Tool
CUSP Toolkit
Health care organizations can increase the extent to which they learn from defects.
Problem statement: Health care organizations can increase the extent to which they learn from defects. We define this learning as reducing the probability that a future patient will be h…
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www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-cognitive-load3.html
May 01, 2024 - Cognitive Load Theory and Its Impact on Diagnostic Accuracy
Interplay Between Cognitive Load and Diagnostic Accuracy
Previous Page Next Page
Table of Contents
Cognitive Load Theory and Its Impact on Diagnostic Accuracy
Introduction to Diagnostic Errors
Fundamental Concepts for Understanding Cogn…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/cusptoolkit/toolkit/learndefects.doc
June 02, 2025 - Learn From Defects Tool
Problem statement: Health care organizations can increase the extent to which they learn from defects. We define this learning as reducing the probability that a future patient will be harmed. Most often clinicians recover from mistakes by reducing risks to the patient who suffered a defect.
Wh…
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www.ahrq.gov/news/newsletters/e-newsletter/932.html
October 01, 2024 - Highlighting the Urgent Need for Research on Improving Delivery of Preventive Services to People with Disabilities
Issue Number
932
AHRQ News Now is a weekly newsletter that highlights agency research and program activities.
October 8, 2024
AHRQ Stats: In-Hospital Sepsis Mortality Rate Disparities While…
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www.ahrq.gov/sites/default/files/wysiwyg/ncepcr/tools/PCMH/pcpf-module-19-kickoff-meetings.pdf
September 01, 2015 - Module 19: Conducting a Kickoff Meeting
Primary Care
Practice Facilitation
Curriculum
Module 19: Conducting a Kickoff Meeting
Agency for Healthcare Research and Quality
Advancing Excellence in Health Care www.ahrq.gov
…
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa-2/133-translating-research-into-practice-fg.docx
April 01, 2025 - AHRQ Safety Program for MRSA Prevention: Targeting SSI
Translating Research into Practice (TRiP)
Surgical Services
For: Cardiac, Hip and Knee Joint Replacement, and Spinal Fusion Surgeries
Slide Title and Commentary
Slide Number and Slide
Translating Research into Practice (TRiP)
SAY:
This presentation is on Trans…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol3/Leape.pdf
June 02, 2025 - Prologue -- Where the Rubber Meets the Road
1
Prologue
Where the Rubber Meets the Road
Lucian L. Leape
Traditionally, a primary focus of patient safety research has been to analyze
data to identify problems and demonstrate that a new practice will lead to
improved quality or safety. Much less research att…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/situ/simulation_facguide.pdf
May 01, 2017 - AHRQ Safety Program for Perinatal Care: Establishing a Program of In Situ Simulations
AHRQ Safety Program for Perinatal Care
Establishing a Program of In Situ Simulations
AHRQ Publication No. 17-0003-22-EF
May 2017
SAY:
Establishing a Program of In Situ Simulations
is a pillar of the AHRQ Safety Program for…
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www.ahrq.gov/sites/default/files/2024-07/peck-report.pdf
January 01, 2024 - Mitchell Dvorak, Executive Director,
Consumers Advancing Patient Safety, assisted in drafting appendices … administrators (including acute, ambulatory and long-term care
facilities)
Healthcare facilities executive … Irving, TX 75039
(W) 972-830-0224
(F) 972-830-0332
lmisuk@vha.com
Virginia Morrison, JD
Executive … 77030
(W) 713-745-1357
(F) 713-745-4437
(H) 281-293-0175
jasonetchegaray@yahoo.com
Roger Fritz
Executive
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www.ahrq.gov/workingforquality/events/webinar-federal-agency-alignment-to-the-six-priorities.html
November 01, 2016 - Nancy Wilson, Executive Lead for the National Quality Strategy, will give a brief overview of the Strategy
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www.ahrq.gov/sites/default/files/wysiwyg/evidencenow/tools-and-materials/key_drivers_descriptions.pdf
February 01, 2019 - EvidenceNow Key Drivers and
Change Strategies
EvidenceNow Key Drivers and
Change Strategies
Tools & Resources
Change Strategy:
Develop a process to search for
new evidence and other changes
related to Key Driver 1
Change Strategy:
Develop an inter-professional QI
team and other changes related to
Key Driver…
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www.ahrq.gov/evidencenow/tools/keydrivers/description.html
October 01, 2020 - EvidenceNow Key Drivers and Change Strategies
Below are descriptions of each key driver and change strategy in the EvidenceNOW Key Driver Diagram.
Key Driver 1: Seek, select, and customize the best evidence for use by the practice
The practice of medicine evolves in response to new knowledge about what care…
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Scanlon_62.pdf
March 25, 2008 - Risk-Based Patient Safety Metrics
Risk-Based Patient Safety Metrics
Matthew C. Scanlon, MD; Ben-Tzion Karsh, PhD; Kelly A. Saran, MS, RN
Abstract
Patient safety programs require meaningful metrics. Dominant frameworks are based on two
safety metrics: one that seeks to identify, measure, and eliminate error an…