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Showing results for "failure".

21. Phone Call Role Play (pdf file)
    cahps.ahrq.gov/sites/default/files/publications/files/phoneroleplay.pdf
    February 14, 2013 - PATIENT: Yes, I was admitted with congestive heart failure. It was the second time this year. … CALLER: Could you tell me your understanding of congestive heart failure? … Since you left the hospital, do you feel your congestive heart failure has improved, worsened, or not

22. TeamSTEPPS 2.0: ASTD Coaching Self-Assessment Form (pdf file)
    cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/instructor/fundamentals/module9/coachselfasfm.pdf
    March 20, 2014 - Dealing with Failure. … Don’t wait until you see either perfection or failure on the task. … • Dealing with Failure. … Patience can be a virtue or an enabler of more failure. Use it wisely.

23. TeamSTEPPS Coaching Feedback Form (pdf file)
    cahps.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/tools/ts-coaching-feedback-form.pdf
    May 31, 2023 - Understanding Performance Improvement Setting Performance Goals Rewarding Improvement Dealing With Failure

24. C1 Prioritization Matrix (xls file)
    cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/c2_combo_prioritizationworksheetexample.xlsx
    July 01, 2016 - Metabolic Derangement 0.9 1.5 4 $120,629 $ 482,516 N 3 3 2 Y Y Y Y Y PSI 11 Postoperative Respiratory Failure … Y Y Y Y IQI 15 AMI Mortality   6.5 5.0 16 $38,000 $ 608,000 N 3 2 2 Y Y Y Y Y IQI 16 Heart Failure … Hemorrhage or Hematoma Rate 0.0 4.9 0 $75,932 $ - 0 N 6 6 6 Y Y Y Y Y PDI 09 Postoperative Respiratory Failure

25. Coaching Feedback Form (pdf file)
    cahps.ahrq.gov/sites/default/files/wysiwyg/teamstepps/longtermcare/module9/ts2-0ltc_module9_coaching_feedback.pdf
    April 24, 2017 - Performance Improvement Setting Performance Goals Rewarding Improvement Dealing With Failure

26. TeamSTEPPS 2.0: Coaching Feedback Form (pdf file)
    cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/instructor/fundamentals/module9/coachfdbk.pdf
    March 20, 2014 - Performance Improvement Setting Performance Goals Rewarding Improvement Dealing With Failure

27. TeamSTEPPS Specialty Scenarios: ICU (pdf file)
    cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/instructor/scenarios/icu.pdf
    March 19, 2014 - Point out other teamwork issues, such as failure to communicate essential information on the patient … patient care by adhering to a protocol designed to prevent decannulation and possible respiratory failure … Lack of knowledge about the plan of care contributed to the team failure.

28. NPSD Data Spotlight - Patient Safety and COVID-19: A Qualitative Analysis of Concerns During the Public Health Emergency (pdf file)
    cahps.ahrq.gov/sites/default/files/wysiwyg/npsd/data/spotlights/spotlight-ptsafety-and-covid-19.pdf
    November 01, 2021 - These descriptions of events included: • Improper screening or failure to ask screening questions … • Failure to collect swab • Miscommunication between staff on testing procedures • Lack of feedback … Additionally, nearly half of the records reviewed related to testing (n = 16) noted a failure of the … • Patient discharge without providing test results Transfer-related concerns often involved the failure … medical/surgical device concerns (n = 14; 4.7%), the most commonly described incident was a device failure

29. CAUTI Sustainability: Embedding CAUTI Policies, Using Data to Monitor Proress and Hardwiring CUSP Principles | Agency for Healthcare Research and Quality
    cahps.ahrq.gov/hai/cauti-tools/archived-webinars/cauti-sustainability-slides.html
    December 01, 2017 - 17 The Power of Measuring Results If you do not measure results, you can not tell success from failure … If you can not reward success, you are probably rewarding failure. … If you can not recognize failure, you can not correct it. … It is the result of preparation, hard work, and learning from failure.” General Colin L. … On the way down, failure feeds on itself.

30. St. Joseph’s Hospital Improves Patient Safety Using AHRQ Tools | Agency for Healthcare Research and Quality
    cahps.ahrq.gov/news/newsroom/case-studies/201511.html
    May 01, 2015 - the hospital used AHRQ's RED toolkit to support patients who had been treated for congestive heart failure … As a result, heart failure rate readmissions were reduced from 10 percent to zero," she said.

31. Strategy 6P: Service Recovery Programs | Agency for Healthcare Research and Quality
    cahps.ahrq.gov/cahps/quality-improvement/improvement-guide/6-strategies-for-improving/customer-service/strategy6p-service-recovery.html
    April 01, 2022 - dissatisfied or lost members or patients by identifying and fixing the problem or making amends for the failure … Letting the person tell their story and describe the impact of the failure is essential. … Commit to identifying failure points in the system Using complaint data, identify failure points

32. Tool 1: Readmission Data Analysis and Interpretation (xls file)
    cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/medicaidreadmitguide/mcaidread_tool1_data_analysis_final.xlsx
    September 20, 2016 - 120 500 24% 5% Sepsis 100 500 20% 4% Psychosis 80 400 20% 3% COPD 70 300 23% 3% Renal Failure … Cellulitis w/o MCC 20 150 13% 1% Total, Top 10 550 Total, All Readmissions 2550 22% Heart Failure … 200 1300 15% 8% COPD 30 300 10% 1% Intracranial hemorrhage 25 50 50% 1% Renal failure with CC … with MCC 15 80 19% 1% Psychosis 15 100 15% 1% UTI 15 80 19% 1% Sepsis 10 145 7% 0% Respiratory failure … 0% Medicaid Cellulitis 10 100 10% 0% COPD with MCC 5 30 17% 0% Chest pain 5 35 14% 0% Renal failure

33. TeamSTEPPS Specialty Scenarios: Neonatal ICU (pdf file)
    cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/instructor/scenarios/neonatalicu.pdf
    March 19, 2014 - Instructor Comments  The case represents teamwork failure, a missing shared mental model, poor communications … , and failure of Conflict resolution.

34. TeamSTEPPS Fundamentals Course: Module 5. Situation Monitoring | Agency for Healthcare Research and Quality
    cahps.ahrq.gov/teamstepps/instructor/fundamentals/module5/igsitmonitor.html
    March 01, 2019 - They are the result of team members' failure to: Share information with the team. … Here are some examples of where failure can occur in the STEP process: Status of the Patient : Failure … Team : Failure to assist a team member who you know is overloaded. … Environment : Failure to know where the necessary equipment is stored. … Progress Toward Goal : Failure to call a huddle and update the team when the plan has changed.

35. TeamSTEPPS Specialty Scenarios: Ambulatory Care (pdf file)
    cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/instructor/scenarios/ambulatory.pdf
    March 19, 2014 - Scenarios Ambulatory Care Scenario 1 Appropriate for: All Specialties Setting: Clinic A renal failure … Failure to share information has a detrimental effect on patient care and may result in delayed diagnosis … This failure to communicate as soon as possible may have contributed to his demise.

36. TeamSTEPPS® Instructor Manual: Specialty Scenarios | Agency for Healthcare Research and Quality
    cahps.ahrq.gov/teamstepps/instructor/scenarios/icu.html
    March 01, 2014 - Point out other teamwork issues, such as failure to communicate essential information on the patient's … safe patient care by adhering to a protocol designed to prevent decannulation and possible respiratory failure … Lack of knowledge about the plan of care contributed to the team failure.

37. Executive Briefing
    cahps.ahrq.gov/sites/default/files/wysiwyg/teamstepps/leadership-brief/ts-leadershipbrief.pptx
    January 01, 2013 - the sentinel events that were reported to them over the last 10 years and identified communication failure … reviewing a variety of sources, including adverse event and near-miss reports, root cause analyses or failure … graduates and identifying standards of performance. 18 Importance of Communication Communication failure … as the leading root cause of sentinel events over the past 10 years (Joint Commission) Communication failure … the sentinel events that were reported to them over the last 10 years and identified communication failure

38. Situation Monitoring (Instructor Guide) (pdf file)
    cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/instructor/fundamentals/module5/igsitmonitor.pdf
    February 12, 2014 - They are the result of team members’ failure to: • Share information with the team; • Request … Here are some examples of where failure can occur in the STEP process: • Status of the Patient: … Failure to take a patient’s vital signs • Team: Failure to assist a team member who you know is … overloaded • Environment: Failure to know where the necessary equipment is stored • Progress … Toward Goal: Failure to call a huddle and update the team when the plan has changed

39. Using TeamSTEPPS to Create Change ... (pt 2/3)
    cahps.ahrq.gov/sites/default/files/wysiwyg/teamstepps/webinars/2017-materials/teamstepps-webinar-080917.pptx
    January 01, 2017 - leverage social/peer pressure to help drive change. 24 Change is Not Easy If you want change, failure … is part of the deal Not failure of the mission, but failure in route.

40. Long COVID is a Case Study of Our Fractured Healthcare System | Agency for Healthcare Research and Quality
    cahps.ahrq.gov/news/blog/ahrqviews/long-covid.html
    March 01, 2023 - Each represented a failure of our healthcare system to handle a new and growing challenge that requires … But our failure to address Long COVID has revealed severe, life-threatening gaps in care.