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www.qualitymeasures.ahrq.gov/npsd/data/dashboard/index.html
October 01, 2023 - and unsafe conditions, then further examines incidents and near misses along with their contributing factors … analyses by age, deeper explorations of common activities prior to fall, and enhanced analyses of risk factors … It also features new incident-specific near misses-specific analyses that examine their contributing factors
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www.qualitymeasures.ahrq.gov/evidencenow/projects/heart-health/research-results/research/collection.html
March 01, 2021 - Southwest cooperative conducted interviews with practices to understand the internal and external factors … Internal factors included: practice structure, staffing, priorities, change processes, and methods of … External factors included: concurrent/competing QI projects and health IT infrastructure. … practices’ motivations and expectations, cooperative organization, and technological and/or geographic factors
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www.qualitymeasures.ahrq.gov/patient-safety/settings/hospital/candor/modules/notes4.html
August 01, 2022 - Continuous organizational learning as a result of identification of contributing factors that might help … 30-45 business days after the event, the investigation should allow for the determination of causal factors … By focusing on system processes and factors that facilitated the event, adjustments can be made to minimize … Continuous organizational learning—this allows for identification of contributing factors that led to … Create solutions—once contributing factors and unrelated hazards are identified, sustainable and effective
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www.qualitymeasures.ahrq.gov/professionals/prevention-chronic-care/improve/coordination/webinar03/logicmodelsl.html
July 01, 2013 - Contextual factors that may influence the intervention’s ability to produce results. … What contextual factors are likely to affect the process? … Using a logic model to explore how implementation factors related to fidelity relate to fidelity domains … Slide 25 Qualitative Analysis Reveal Implementation Factors
Individuals: Program director knowledge
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www.qualitymeasures.ahrq.gov/sops/bibliography/index.html?page=5
January 01, 2024 - Certified registered nurse anesthetist perceptions of factors impacting patient safety. … A comparative study on effective factors in patient safety culture from the nursing staff points of view … A cross-sectional analysis investigating organizational factors that influence near-miss error reporting … The influence of organizational factors on patient safety: Examining successful handoffs in health care
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www.qualitymeasures.ahrq.gov/sops/bibliography/index.html?page=2
January 01, 2024 - Multilevel analysis of individual, organizational, and regional factors associated with patient safety … The enabling, enacting, and elaborating factors of safety culture associated with patient safety: A multilevel … Patient safety culture and associated factors among health care providers in Bale Zone hospitals, Southeast … A safety evaluation of the impact of maternity-orientated human factors training on safety culture in
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/news/events/ahrq-research-summit/mcdonald-summit2016-breakout.pdf
October 05, 2016 - to
Patients and Their Families
Kathryn McDonald
Stanford University
What We Know:
Key Shaping Factors … Edmondson & Schein, 2011
What We Don’t Know
Enabler and Show Stoppers
What organizational contextual factors … Theoretically critical for building in diagnostic safety culture
Organizations
What We Know:�Key Shaping Factors
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/news/events/ahrq-research-summit/brady-summit2016-plenary.pdf
September 28, 2016 - Workforce
(including
clinician
burnout)
Understand
Health Care
Risks &
Hazards
Clinical
Factors … Work System
Factors
Safe Practices
Patient Safety
Culture
Patient
Engagement
Alignment
with … topics and potential solutions:
► Use of Data and Measurement
► Health IT’s Role
► Organizational Factors
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/patient-safety/settings/mcc-summit/mcc-summit-vick-wolff.pdf
November 01, 2020 - utm_content=creditCopyText
#2: Infrastructure
9
• How do system-level and community-level structural factors … • How do system- and community-level factors interfere with or
support engagement, and how do we design
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/cauti-learning-from-defects.docx
April 01, 2022 - This worksheet will help your team learn what happened, identify the factors that may have contributed … What factors contributed?
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/cahps/news-and-events/events/webinars/cahps-creative-strategies-nembhard.pdf
January 01, 2014 - Measuring Implementation And
Contextual Factors
• Implementation: Office visit frequency
► CG-CAHPS … program’s early months to address
outstanding care needs and self-management training
• Contextual factors … 6
m
on
th
s
P < 0.001
Getting Greater Improvement In Patient
Care Experiences
Contextual factors … Quasi-Experiment
Measuring Patient Care Experiences And Teamwork
Measuring Implementation And Contextual Factors
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/evidencenow/results/research/interview-protocol-staff-ny.pdf
August 23, 2018 - practices to help make changes that
can improve quality of care for patients with cardiovascular risk factors … How do you help
patient’s access community programs to help them deal with cardiovascular risk factors … What are the biggest challenges facing your patients with cardiovascular disease risk factors? … Small Practices and Other Contextual Factors
There are a few more questions I’d like to ask about your
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www.qualitymeasures.ahrq.gov/research/findings/final-reports/ssi/ssi2.html
April 01, 2018 - Initial Risk Factors
Appendix J. Additional Risk Factors
Appendix K. … Final Risk Factors
Appendix L. … Final data sheet submitted by each site that included the list of potential SSI risk factors and other … Focus Group Risk Factors
Appendix Q. Surgeon Focus Group Content Analysis
Appendix R. … A strength of our approach was to rigorously differentiate between risk factors for and manifestations
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www.qualitymeasures.ahrq.gov/patient-safety/settings/hospital/fall-prevention/toolkit/implementation.html
January 01, 2013 - fall risk:
Developing mechanisms for the emergency department to communicate a patient's risk factors … Are data already in the system that can be used as part of a new process to assess fall risk factors? … the most logical place in the record to collect/organize/assess information about patient fall risk factors … Fall risk factor report that summarizes which patients on the unit have specific risk factors. … Strategies for dealing with such reluctance will depend on a number of factors, including the stage of
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www.qualitymeasures.ahrq.gov/antibiotic-use/long-term-care/safety/system-change.html
June 01, 2021 - List factors that may compromise patient safety.
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www.qualitymeasures.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/education-bundles/infection-prevention/environment-and-equipment/environ-equip-slides.html
March 01, 2017 - Risk factors
Use of common measuring device between residents with indwelling urinary catheters. … Nursing home facility risk factors for infection and hospitalization: importance of registered nurse … turnover, administration, and social factors. … Nursing home facility risk factors for infection and hospitalization: importance of registered nurse … turnover, administration, and social factors.
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www.qualitymeasures.ahrq.gov/research/findings/final-reports/stpra/stpraapc.html
April 01, 2018 - and Outcome Engineering, to conduct a proactive risk assessment of the policy and clinical practice factors … This general process map will, in turn, be used to identify where potential human factors risks exist … We will then use this general process map to identify where potential human factors risks exist in surgical … What were the major risk factors encountered? Did a surgical site infection occur?
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/implementation/long-term-modules/module2/defects-spanish.docx
April 21, 2014 - Programa de seguridad de la AHRQ para cuidados a largo plazo: HAI/CAUTI
Kit de herramientas de seguridad para cuidados a largo plazo
Aprender de los defectos
Objetivo: Identificar los tipos de sistemas que contribuyeron al defecto (un suceso o una situación que usted no desea que se repita) y planificar los pasos…
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www.qualitymeasures.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/instructor/fundamentals/module5/ebsitmonitor.pdf
January 01, 2013 - Hum Factors
1995;37(1):20-31.
11. Flin R, Yule S, Paterson-Brown S, et al. … Hum Factors 1995;37(1):123-36.
16. Mohammed S, Ferzandi L, Hamilton K. … Hum Factors 1999;41(1):61-71.
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www.qualitymeasures.ahrq.gov/evidencenow/projects/heart-health/research-results/research/cooperative-context.html
March 01, 2021 - This form was used by the national evaluation team to collect data from each cooperative on what factors