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healthcare411.ahrq.gov/health-literacy/improve/precautions/tool7a.html
March 01, 2024 - Grant Application, Review & Award Process
Grant Application Basics
Application Forms … 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 … Help With Medicines Poster
Get Patient Feedback: Tool 17
Patient Portal Feedback Form
Suggestion
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healthcare411.ahrq.gov/nhguide/toolkits/determine-whether-to-treat/toolkit1-suspected-uti-sbar.html
October 01, 2016 - Grant Application, Review & Award Process
Grant Application Basics
Application Forms … 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.
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healthcare411.ahrq.gov/sops/databases/research-datasets.html
March 01, 2023 - Grant Application, Review & Award Process
Grant Application Basics
Application Forms … SOPS De-Identified Data Research Abstract Form (Word, 32 KB)—Researchers requesting de-identified data … must submit a completed form outlining the proposed use of the data. … Sample SOPS De-Identified Data Research Abstract Form (PDF, 376 KB)—Shows the form completed with sample … data must submit a completed form outlining the proposed use of the data.
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healthcare411.ahrq.gov/hai/cusp/toolkit/bckgrnd-qi-team.html
December 01, 2012 - Grant Application, Review & Award Process
Grant Application Basics
Application Forms … About the CUSP Method
Modules
Background Quality Improvement Team Information Form … Universal and Targeted
Tools
Background Quality Improvement Team Information Form … Alternate Formats
Background Quality Improvement Team Information Form [ - 211.5 KB] … created December 2012
Internet Citation: Background Quality Improvement Team Information Form
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healthcare411.ahrq.gov/health-literacy/improve/precautions/tool5.html
February 01, 2024 - Grant Application, Review & Award Process
Grant Application Basics
Application Forms … 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 … There is also a teach-back question on the Communication Observation Form .
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healthcare411.ahrq.gov/funding/process/app-forms/index.html
November 01, 2015 - change from paper to electronic filing, the current PHS 398 application will be replaced by the Standard Form … Following this advice will ensure you have the latest forms and correct application package. … Research Grants
Form/Application Instructions
Description/Comments
SF424 (R&R) (Word File, 26 … Fishers Lane
Rockville, MD 20857
Phone: (301) 427-1447
Fax: (301) 427-1462
Fellowships
Form … Kirschstein National Research Service Award Individual Fellowship Application Form ** to be used ONLY
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healthcare411.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/staff-safety-assessment.docx
June 01, 2021 - AHRQ Safety Program for Improving Antibiotic Use
Staff Safety Assessment
PURPOSE OF THIS FORM: … All health care providers are encouraged to complete this form. … Consider asking all staff members to complete this form at least semiannually.
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healthcare411.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4_combo_bestpracticescover.pdf
June 05, 2016 - The best practices forms are not meant to replace validated guidelines. … Which QIs have best practices forms? … Best practices forms have been developed for all PSIs
and PDIs for which there was sufficient evidence … Best practices forms exist for the following 14 PSIs:
• PSI 03 Pressure Ulcer Rate
• PSI 05 Retained … to be captured by one best
practices form.
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healthcare411.ahrq.gov/health-literacy/improve/precautions/tool10.html
February 01, 2024 - Grant Application, Review & Award Process
Grant Application Basics
Application Forms … 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 … Plans: Tool 15
My Action Plan
Help Patients Take Medicine Correctly: Tool 16
Medicine Reminder Form
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healthcare411.ahrq.gov/hai/tools/surgery/modules/implementation/audit-briefing-slides.html
December 01, 2017 - Grant Application, Review & Award Process
Grant Application Basics
Application Forms … What forms and structures should be in place? … Image: Logistics section of briefing form:
Who initiated briefing?
Surgery attending. … INTRAOP
Back of the form .
Operating room nurse coordinates. … INTRAOP
Back of the form .
Operating room nurse coordinates.
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healthcare411.ahrq.gov/funding/grant-mgmt/recognition_ahrq-funded_study.html
November 01, 2021 - Grant Application, Review & Award Process
Grant Application Basics
Application Forms … Please use this PDF form [153.4 KB] to submit the information below. … Contact journalpublishing@ahrq.hhs.gov with any questions or assistance with this form. … The fillable PDF form linked above contains the following fields to submit information. … This page cannot submit information, and is intended only to identify the information requested in the form
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healthcare411.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/instructor/contents.pdf
March 21, 2014 - Management: How to
Achieve a Culture of Safety
Module 9: Coaching Workshop
• Coaching Feedback Form … • Coaching Scenarios
• Coaching Self-Assessment Form
Module 10: Measurement
• Evaluating TeamSTEPPS … Workshop
• TeamSTEPPS Implementation Guide
Module 12: Practice Teaching Session
• Teaching Feedback Form … Planning Workshop
Module 12: Practice Teaching Session
TAB F MEASURES
Sample Course Evaluation Form
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healthcare411.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/medication-mgmt-sample-process.pdf
January 12, 2017 - Using the Medication List form, go through the prescription medications one by one:
a. … Check whether the medication is expired and note that on the Medication List form.
d. … Indicate on the Medication List form whether the patient is taking the
medication as prescribed. … Page does not require timed responses
Navigation links Passed Navigation links are not repetitive
Forms … Rule Name Status Description
Tagged form fields Passed All form fields are tagged
Field descriptions
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healthcare411.ahrq.gov/teamstepps/instructor/fundamentals/module9/coachscenarios.html
March 01, 2014 - Grant Application, Review & Award Process
Grant Application Basics
Application Forms … Mark your observations on the coaching feedback form. … Mark your observations on the coaching feedback form. … Mark your observations on the coaching feedback form. … Mark your observations on the coaching feedback form.
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healthcare411.ahrq.gov/hai/cusp/modules/identify/identify.html
December 01, 2012 - Grant Application, Review & Award Process
Grant Application Basics
Application Forms … The conversation is the mechanism that combines that knowledge into a new, more understandable form for … Engage the senior executive in addressing the safety issues identified on the form.
Step 2. … Use the form during safety rounds to identify safety issues, identify potential solutions, and identify … Keep the project leader apprised of the information on this form.
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healthcare411.ahrq.gov/health-literacy/research/tools/index.html
December 01, 2022 - Grant Application, Review & Award Process
Grant Application Basics
Application Forms … Pub Med ID (PMID) : 20500222 [Full text available in PubMedCentral]
Contents:
SAHL-S Test Form & … User’s Guide (Select for PDF [36.33 KB] ) SAHL-E Test Form & User’s Guide (Select for PDF [53.04 … KB] )
SAHL-S Test Form
Stem
Key or Distracter
"No sé"
(Don't know)
1. empleo
__trabajo … Development and validation of a short-form, rapid estimate of adult literacy in medicine.
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healthcare411.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/instructor/fundamentals/module9/coachscenarios.pdf
March 20, 2014 - Mark
your observations on the coaching feedback form. … Mark
your observations on the coaching feedback form. … Mark
your observations on the coaching feedback form. … Mark
your observations on the coaching feedback form. … Mark
your observations on the coaching feedback form.
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healthcare411.ahrq.gov/cahps/cahps-database/research-datasets/index.html
January 01, 2024 - Grant Application, Review & Award Process
Grant Application Basics
Application Forms … from the CAHPS Databases, please submit the following:
CAHPS De-Identified Data Research Abstract Form … (PDF, 230 KB)—Please complete and submit this form to outline the proposed use of the data. … Sample CAHPS De-Identified Research Abstract Form (PDF, 247 KB)—Shows the form completed with sample … westat.com (Subject line: CAHPS De-Identified Data Request)
Timeline
All completed research abstract forms
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healthcare411.ahrq.gov/sites/default/files/wysiwyg/patient-safety/patient-prep-card.pdf
November 30, 2016 - Page does not require timed responses
Navigation links Passed Navigation links are not repetitive
Forms … Rule Name Status Description
Tagged form fields Passed All form fields are tagged
Field descriptions … Passed All form fields have description
Alternate Text
Rule Name Status Description
Figures alternate
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healthcare411.ahrq.gov/antibiotic-use/long-term-care/safety/index.html
January 01, 2024 - Grant Application, Review & Award Process
Grant Application Basics
Application Forms … Antibiotic Use Commitment Poster (DOCX, 870 KB)
Staff Safety Assessment Form (DOCX, 330 KB)
Implementation … Guide (PDF, 402 KB)
Learning From Antibiotic–Associated Adverse Events Form (DOCX, 227 KB)
Gap … Analysis Tool (DOCX, 382 KB)
The Four Moments of Antibiotic Decision Making Form and Guide