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www.cpsi.ahrq.gov/news/newsletters/e-newsletter/848.html
January 01, 2023 - They found that failures in communication about changes in medication doses were common, and one in four
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www.cpsi.ahrq.gov/cahps/news-and-events/events/2020-meeting-summary.html
December 01, 2020 - Recommendations based on this work include focusing on improvements in the implementation process rather than failures
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www.cpsi.ahrq.gov/teamstepps/instructor/essentials/implguide3.html
November 01, 2018 - Refresher
Turnover
Emergency procedures (rapid identification of and recovery from errors and process failures
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www.cpsi.ahrq.gov/teamstepps-program/curriculum/implement/activity/plan.html
February 01, 2024 - How will you reduce the probability or severity of these failures?
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www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/c2_combo_prioritizationworksheetexample.xlsx
July 01, 2016 - C1 Prioritization Matrix
Prioritization Worksheet
Toolkit for Using the AHRQ Quality Indicators
How To Improve Hospital Quality and Safety
AHRQ Quality Indicators Prioritization Worksheet Example
Section 1- Blue Section 2-Green Section 3-Purple Section 4-Orange
Own Rate and National Benchmark Estima…
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www.cpsi.ahrq.gov/teamstepps/instructor/essentials/implguide2.html
November 01, 2018 - Emergency procedures (rapid identification of and recovery from errors and process failures.)
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www.cpsi.ahrq.gov/sites/default/files/wysiwyg/research/findings/factsheets/translating/action3/ACTION%20-III-2019-Project-Summaries.pdf
January 01, 2019 - testing, and promoting a resource (e.g., toolkit,
improvement guide) that will address one or more failures … engage patients and families in the diagnostic
process, and a resource that will address one or more failures … literature, targeting the identification of materials, tools, approaches, and toolkits that may
mitigate failures … develop a resource (e.g., toolkit, improvement
guide) for providers that will address one or more failures … Diagnostic Safety
• TeamSTEPPS Module
• Patient and Family Engagement Resource
• Resource to Address Failures
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www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol4/Wakefield2.pdf
January 01, 2003 - When errors
occur, they are likely to be viewed as failures of character (i.e., the error occurred
-
www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/officebasedcare/impworkbook.pdf
December 11, 2015 - Refresher
o Turnover
o Emergency procedures (rapid identification of and recovery from errors and process failures
-
www.cpsi.ahrq.gov/teamstepps/officebasedcare/impworkbook.html
December 01, 2015 - Emergency procedures (rapid identification of and recovery from errors and process failures).
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www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/instructor/fundamentals/module5/igsitmonitor.pdf
February 12, 2014 - Situation Monitoring (Instructor Guide)
SITUATION MONITORING
SUBSECTIONS
• Teamwork Exercise #2
• STEP
• Situation Awareness
• Shared Mental Models
TIME: 45 minutes
Slide
…
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www.cpsi.ahrq.gov/teamstepps/instructor/essentials/implguide1.html
November 01, 2018 - How will you reduce the probability and/or severity of these failures?
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www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/medicaidreadmitguide/aspire_webinar1/aspire_webinar1.ppt
January 01, 2011 - Designing & Delivering Whole-Person Transitional Care The Hospital Guide to Reducing Medicaid Readmissions Webinar 1
Designing & Delivering Whole-Person Transitional Care
The Hospital Guide to Reducing Medicaid Readmissions
Webinar 1: Introduction & Overview
Agenda
Introduction to the AHRQ Reducing Medicaid Rea…
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www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4_combo_bestpracticescover.pdf
June 05, 2016 - Introduction to the Quality Indicators Best Practices Tool
Toolkit for Using the AHRQ Quality Indicators
How To Improve Hospital Quality and Safety
i Tool D.4
Introduction to the Quality Indicators Best Practices Tool
What is the purpose of this tool? The purpose of this tool is to provide:
• Detailed descr…
-
www.cpsi.ahrq.gov/npsd/data/dashboard/index.html
October 01, 2023 - Skip to main content
An official website of the Department of Health and Human Services
Careers
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FAQs
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…
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www.cpsi.ahrq.gov/sites/default/files/wysiwyg/action-alliance/high-reliability-journey-slides.pptx
September 26, 2023 - VHA's Journey to High Reliability: Advancing Toward Zero Harm and Becoming a Learning Health System
September 26, 2023
Pre-Decisional Deliberative Document
Internal VA Use Only
Advancing Toward Zero Harm and
Becoming a Learning Health System
Gerard R. Cox, MD, MHA
Assistant Under Secretary for Health for Quality & …
-
www.cpsi.ahrq.gov/news/blog/ahrqviews/long-covid.html
March 01, 2023 - Skip to main content
An official website of the Department of Health and Human Services
Careers
Contact Us
Español
FAQs
Search all AHRQ sites
Search small
Search
Menu
…
-
www.cpsi.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/medicaidmgmt/mm2.html
October 01, 2014 - the program is implemented, communicating routinely with stakeholders regarding program successes, failures … Communicating routinely with lobbyists regarding program successes, failures, and new initiatives will
-
www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/medicaidreadmitguide/aspire_webinar2/aspire_webinar2.pptx
January 01, 2015 - Designing & Delivering Whole-Person Transitional Care The Hospital Guide to Reducing Medicaid Readmission Webinar 2
Designing & Delivering Whole-Person Transitional Care
The Hospital Guide to Reducing Medicaid Readmissions
Webinar 2: Analyze Data and Patient/Caregiver Perspectives
(Section 1 of the Guide)
Agenda
…
-
www.cpsi.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/nicu_toolkit/nicupacket-apb-breastmilk.pdf
December 13, 2013 - NICU Family Information Packet, Appendix B, Breast Milk
Breast Milk
Benefits
■ Optimal food for almost all infants regardless of gestational age.
■ Has been shown to improve subsequent mental development in term/preterm infants as well
as provide enhanced protection against infection.
■ Premature infants with …