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1. Pemat Form (xls file)
   pcmh.ahrq.gov/sites/default/files/wysiwyg/professionals/prevention-chronic-care/improve/self-mgmt/pemat/pemat_form.xls
   November 01, 2013 - PEMAT Patient Education Materials Assessment Tool (PEMAT) Auto-Scoring Form   An Instrument To … You may refer to the material at any time while you complete the form. … This PEMAT Auto-Scoring Form automatically calculates an overall understandability and actionability

2. Coaching Feedback Form (pdf file)
   pcmh.ahrq.gov/sites/default/files/wysiwyg/teamstepps/longtermcare/module9/ts2-0ltc_module9_coaching_feedback.pdf
   April 24, 2017 - Coaching Feedback Form Coaching Workshop Coaching Feedback Form INSTRUCTIONS: While observing … the scripted coaching practice exercise, use this form to document the demonstrated competencies of … particular scenario, and the observer watches the interaction and notes on the coaching observation form … Responding to Requests Following Through TeamSTEPPS 2.0 for Long-Term Care Coaching Feedback Form

3. TeamSTEPPS Coaching Feedback Form (pdf file)
   pcmh.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/tools/ts-coaching-feedback-form.pdf
   May 31, 2023 - TeamSTEPPS Coaching Feedback Form Coaching Feedback Form INSTRUCTIONS While observing the scripted … coaching practice exercise, use this form to document the demonstrated competencies of the designated … particular scenario, and the observer watches the interaction and notes on the coaching observation form … Difficult Situations Execution Responding to Requests Following Through Coaching Feedback Form

4. ASTD Coaching Self-Assessment Form (pdf file)
   pcmh.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/tools/astd-coaching-self-assessment-form.pdf
   May 31, 2023 - ASTD Coaching Self-Assessment Form … ASTD Coaching Self-Assessment Form Instructions … ☐ ☐ ☐ ☐ ASTD Coaching Self-Assessment Form 2 … ASTD Coaching Self-Assessment Form 4 … Reference: Chen, Chris, Coaching Training, ASTD, 2003 ASTD Coaching Self-Assessment Form 6 ASTD

5. Team-Antibiotic-Review-Form (doc file)
   pcmh.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/improve/team-antibiotic-review-form.docx
   November 01, 2019 - AHRQ Safety Program for Improving Antibiotic Use Team Antibiotic Review Form *Questions 1–6 should … ☐ Yes ☐ No 2 Team Antibiotic Review Form AHRQ Safety Program for Improving Antibiotic Use – … Otherwise this form has been completed.

6. AHRQ’s Easy-to-Understand Telehealth Consent Form | Agency for Healthcare Research and Quality
   pcmh.ahrq.gov/health-literacy/improve/informed-consent/index.html
   September 01, 2020 - Why should we use easy-to-understand telehealth consent forms? … The AHRQ Sample Consent Form must be adapted before using it. … Put your logo on the form. Check with your lawyer before using the form. … If patients cannot use a patient portal, you can mail consent forms (one to sign and return, one for … Clinicians can ask patients to sign and mail back the form.

7. Team Antibiotic Review Form | Agency for Healthcare Research and Quality
   pcmh.ahrq.gov/antibiotic-use/acute-care/improve/team-review.html
   November 01, 2019 - Stewardship Bedside Nurse Collaborate With Microbiology Lab Team Antibiotic Review Form … Ambulatory Care Toolkit Long-Term Care Toolkit Team Antibiotic Review Form … Team Antibiotic Review Form  (DOCX) Completion Guide for Team Antibiotic Review Form  (PDF … 2019 Page originally created November 2019 Internet Citation: Team Antibiotic Review Form

8. TeamSTEPPS Limited English Proficiency Module: Form Letter (pdf file)
   pcmh.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/lep/handouts/lepletter.pdf
   July 30, 2012 - TeamSTEPPS Limited English Proficiency Module: Form Letter [PLACE ON TRAINING ORGANIZER’S LETTERHEAD

9. TeamSTEPPS 2.0: ASTD Coaching Self-Assessment Form (pdf file)
   pcmh.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/instructor/fundamentals/module9/coachselfasfm.pdf
   March 20, 2014 - TeamSTEPPS 2.0: ASTD Coaching Self-Assessment Form TeamSTEPPS 2.0 ASTD Coaching Self-Assessment … Form – D-9-31 Coaching Workshop ASTD Coaching Self-Assessment Form INSTRUCTIONS: The purpose … ASTD Coaching Self-Assessment Form – D-9-32 TeamSTEPPS 2.0 Coaching Workshop Why These Competencies … uncomfortable situations head on, but with tact and TeamSTEPPS 2.0 ASTD Coaching Self-Assessment Form … ASTD Coaching Self-Assessment Form – D-9-34 TeamSTEPPS 2.0 Coaching Workshop Coach’s Plan for Self-Improvement

10. EvidenceNOW: Intervention Tracking Field Note Form | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/evidencenow/projects/heart-health/research-results/research/intervention-tracking-notes-sw.html
    March 01, 2021 - Incontinence Tools for Change EvidenceNOW: Intervention Tracking Field Note Form … Southwest Cooperative Resource: Field Note Tracking Form—Southwest Cooperative (PDF, 151.3 … KB, 5 pages) This implementation tracking form was used by an EvidenceNOW Cooperative's staff to document … created January 2019 Internet Citation: EvidenceNOW: Intervention Tracking Field Note Form

11. EvidenceNOW: Implementation Tracking Form | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/evidencenow/projects/heart-health/research-results/research/implementation-tracking-sw.html
    March 01, 2021 - Incontinence Tools for Change EvidenceNOW: Implementation Tracking Form … Implementation Tracking Note—Southwest Cooperative (PDF, 363.33 KB, 2 pages) This intervention tracking form … originally created January 2019 Internet Citation: EvidenceNOW: Implementation Tracking Form

12. Form Letter | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/teamstepps/lep/handouts/lepletter.html
    December 01, 2012 - Master Trainer Course Research/Evidence Base TeamSTEPPS® Webinars Form … last reviewed December 2012 Page originally created December 2012 Internet Citation: Form

13. SAHL-E Test Form and User's Guide (pdf file)
    pcmh.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/literacy/sahl-e-form-user-guide.pdf
    December 18, 2014 - SAHL-E Test Form and User's Guide The 18 items of SAHL-E, ordered according to item difficulty (keys

14. SAHL-S Test Form and User Guide (pdf file)
    pcmh.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/literacy/sahl-s-form-user-guide.pdf
    December 18, 2014 - SAHL-S Test Form and User Guide The 18 items of SAHL-S, ordered according to item difficulty (keys

15. TeamSTEPPS Measurement Tools | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/teamstepps-program/resources/tools/index.html
    January 01, 2024 -  (PDF, 161 KB) This form will guide you through a self-evaluation exercise that will assist you in … TeamSTEPPS Coaching Feedback Form (PDF, 181 KB) During the scripted coaching practice exercise, the … observer uses this form to document the demonstrated competencies of the designated coach. … TeamSTEPPS Readiness Assessment Form (PDF, 134 KB) This PDF helps institutions answer the question … TeamSTEPPS Training: Evaluation Form (PDF, 354 KB) This course evaluation form for a two-day TeamSTEPPS

16. Sample Automated Telephone System Menu | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/health-literacy/improve/precautions/tool7a.html
    March 01, 2024 - Health Literacy Universal Precautions Toolkit, 3rd Edition Introduction Quick Start Guide Form … Key Strategies for Clear Communication Communication Self-Assessment Communication Observation Form … Insurance Release of Medical Information Appointment Reminder Letter Inclusive Language for Intake Forms … Action Plan Help Patients Remember How and When to Take Their Medicine: Tool 16 Medicine Reminder Form … Help With Medicines Poster Get Patient Feedback: Tool 17 Patient Portal Feedback Form Suggestion

17. How to Obtain Consent for Telehealth | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/health-literacy/improve/informed-consent/obtain.html
    September 01, 2020 - and Funding How to Obtain Consent for Telehealth The purpose of consent forms … Offer to read the form aloud to all patients. … If patients consent: Mail them a copy of the consent form to keep. … If patients can’t use the patient portal, mail consent forms (one to sign and return, one to keep) and … You do not need to wait to get a consent form signed.

18. Lab Results Letter | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/health-literacy/improve/precautions/tool11f.html
    March 01, 2024 - Health Literacy Universal Precautions Toolkit, 3rd Edition Introduction Quick Start Guide Form … Key Strategies for Clear Communication Communication Self-Assessment Communication Observation Form … Insurance Release of Medical Information Appointment Reminder Letter Inclusive Language for Intake Forms … Action Plan Help Patients Remember How and When to Take Their Medicine: Tool 16 Medicine Reminder Form … Help With Medicines Poster Get Patient Feedback: Tool 17 Patient Portal Feedback Form Suggestion

19. Permission To Bill Insurance | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/health-literacy/improve/precautions/tool11d.html
    March 01, 2024 - Health Literacy Universal Precautions Toolkit, 3rd Edition Introduction Quick Start Guide Form … Key Strategies for Clear Communication Communication Self-Assessment Communication Observation Form … Insurance Release of Medical Information Appointment Reminder Letter Inclusive Language for Intake Forms … Action Plan Help Patients Remember How and When to Take Their Medicine: Tool 16 Medicine Reminder Form … Help With Medicines Poster Get Patient Feedback: Tool 17 Patient Portal Feedback Form Suggestion

20. Toolkit 1. Suspected UTI SBAR Toolkit | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/nhguide/toolkits/determine-whether-to-treat/toolkit1-suspected-uti-sbar.html
    October 01, 2016 - Toolkit Effectiveness A study in 12 nursing homes in Texas found that using the Suspected UTI SBAR form … The primary tool in this toolkit is the Suspected UTI SBAR form. … The toolkit includes the following tools: Suspected UTI SBAR form (tool 1) ( PDF ) also available … Introduce the Suspected UTI SBAR form to prescribing clinicians. … for using the form, and a discussion about available technical support.