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www.innovations.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/outcomes/chipra-140-section-5.8.pdf
January 01, 2014 - CHIPRA Pediatric Quality Measures Program (PQMP) Candidate Measure Submission Form (CPCF)
Table … symptom
discomfort and concern; (2) self-report of
health, using the Medical Outcomes
Study Short Form
-
www.innovations.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/outcomes/chipra-81-pgh-7-section-2-tech-specs.pdf
January 01, 2012 - Never – Rarely –
Sometimes – Often -
Always
Healthy
Pathways,
Child Report
Form
Ped Global5 … Never – Rarely –
Sometimes – Often -
Always
Healthy
Pathways,
Child Report
Form
Ped Global6 … Never – Rarely –
Sometimes – Often -
Always
Healthy
Pathways,
Child Report
Form
Details of … To
find the total raw score for a form with all questions answered, sum the values of the response to … Multiply this sum by the total number of
items in the form.
-
www.innovations.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/sensemaking/sensemaking.pptx
May 01, 2017 - Defects
2
CUSP and Sensemaking Tools1
CUSP Tools Sensemaking Tools
Staff Safety Assessment Discovery Form … Safety Issues Worksheet Root Cause Analysis
Learn From Defects Form Failure Mode and Effects Analysis … identify defects or failure - Staff Safety Assessment
- Status of Safety Issues Worksheet - Discovery Form … Analysis
- Probabilistic Risk
Assessment
Tools to examine defects or failures Learn From Defects Form … Causal Tree Worksheet
Coding defects or failures Learn From Defects Form Eindhoven Model
4
AHRQ Safety
-
www.innovations.ahrq.gov/sites/default/files/wysiwyg/teamstepps/longtermcare/module9/ts2-0ltc_module9_coaching_scenarios.pdf
April 24, 2017 - 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.
-
www.innovations.ahrq.gov/antibiotic-use/acute-care/improve/index.html
June 01, 2021 - Grant Application, Review & Award Process
Grant Application Basics
Application Forms … Stewardship
Bedside Nurse
Collaborate With Microbiology Lab
Team Antibiotic Review Form … All ASPs should be making daily interventions to improve antibiotic use; the Team Antibiotic Review Form … AHRQ Safety Program for Acute Care (PDF, 328 KB)
Gap Analysis Tool (DOCX)
Team Antibiotic Review Form
-
www.innovations.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/chipra-89-adhd-behavior-section-2-attach-2.pdf
February 02, 2017 - SNAC Submission Form. … Section 2: Detailed Measure Specifications, Attachment 2: Chart Abstratcion Algorithm
SNAC Submission Form
-
www.innovations.ahrq.gov/teamstepps/longtermcare/index.html
May 01, 2019 - Grant Application, Review & Award Process
Grant Application Basics
Application Forms … Coaching Self-Assessment Form (PDF; 4 pages; 287.6 KB). … Coaching Feedback Form (PDF; 1 page; 121.6 KB). … Coaching Self-Assessment Form (PDF; 4 pages; 287.6 KB). … Coaching Feedback Form (PDF; 1 page; 121.6 KB).
-
www.innovations.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/teach-back-tips-jobaid-final508.pdf
April 04, 2018 - 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
-
www.innovations.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/medmanage-ptfactsheet.pdf
November 27, 2017 - 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
-
www.innovations.ahrq.gov/funding/policies/human-subjects/index.html
June 01, 2022 - Grant Application, Review & Award Process
Grant Application Basics
Application Forms … for any clinical trial conducted or supported by a Common Rule department or agency, one consent form … The consent form must have been used in enrolling participants in order to satisfy this new provision … AHRQ Guidance on Posting Informed Consent Forms for AHRQ-Funded Clinical Trials . … AHRQ Guidance on Posting Informed Consent Forms for AHRQ-Funded Clinical Trials .
-
www.innovations.ahrq.gov/nhguide/toolkits/determine-whether-to-treat/toolkit2-communications-and-decisionmaking.html
November 01, 2016 - Grant Application, Review & Award Process
Grant Application Basics
Application Forms … This toolkit includes the following tools:
A Medical Care Referral Form to document information for … Use the Medical Care Referral form. … The form documents information clinicians need for prescribing decisions and reflects evidence-based … Prescribing clinicians should also be trained to use order forms for treatment other than antibiotics
-
www.innovations.ahrq.gov/teamstepps/officebasedcare/handouts/checklist.html
November 01, 2015 - Grant Application, Review & Award Process
Grant Application Basics
Application Forms … Creating A Handoff Checklist
TeamSTEPPS Primary Care Version Participant Handouts
Directions: Form … If your medical team members are present, form a group of your medical office team members and develop
-
www.innovations.ahrq.gov/health-literacy/improve/index.html
March 01, 2024 - Grant Application, Review & Award Process
Grant Application Basics
Application Forms … AHRQ's Easy-to-Understand Telehealth Consent Form
AHRQ's telehealth consent resources include a … sample telehealth consent form (Word, 27 KB) that is easy to understand and how-to guidance for clinicians … The consent form includes provisions for healthcare providers that have curtailed in-person visits due
-
www.innovations.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/officebasedcare/handouts/courseeval.pdf
December 02, 2015 - ........................ 1 2 3
Comments:
TeamSTEPPS for Office-Based Care Course Evaluation Form … ............................................ 1 2 3
Comments:
Course Evaluation Form – 2 TeamSTEPPS … ...................... 1 2 3
Comments:
TeamSTEPPS for Office-Based Care Course Evaluation Form … Course Evaluation Form – 4 TeamSTEPPS for Office-Based Care
TeamSTEPPS® for Office-Based Care … Additional Comments:
TeamSTEPPS for Office-Based Care Course Evaluation Form –
-
www.innovations.ahrq.gov/health-literacy/improve/precautions/tool2b.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
-
www.innovations.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/supporting/worksheet.docx
May 01, 2017 - Health care providers and senior leader(s)
How to complete this form: Provide as much detail as possible … When to complete this form: It should be completed at least semiannually.
-
www.innovations.ahrq.gov/health-literacy/professional-training/informed-choice/guide.html
September 01, 2020 - Forms
Complex consent forms not understandable to patients and families. … forms being used in your hospital. … Forms and Decision Aids
X percent of informed consent forms will be understandable by culturally … want to track the percentage of informed consent forms assessed, the percentage of forms revised, and … Did anyone help you read the form?
-
www.innovations.ahrq.gov/antibiotic-use/long-term-care/four-moments/index.html
August 01, 2021 - Grant Application, Review & Award Process
Grant Application Basics
Application Forms … Long-Term Care Toolkit
Four Moments
Four Moments Posters
Four Moments Review Form … The Four Moments of Antibiotic Decision Making Review Form and Guide
The Antibiotic Stewardship Team … is encouraged to use Four Moments of Antibiotic Decision Making Form to review 5–10 residents each
-
www.innovations.ahrq.gov/patient-safety/patients-families/engagingfamilies/strategy1/index.html
December 01, 2017 - Grant Application, Review & Award Process
Grant Application Basics
Application Forms … Word version - 2.62 MB ; PDF version - 171.61 KB ]
Patient and Family Advisor Application Form—Form … Microsoft Word version - 462.55 KB ; PDF version - 214.81 KB ]
My Participation Interests - Form … session that contains suggestions for ways to incorporate advisors on short-term projects along with a form
-
www.innovations.ahrq.gov/funding/process/grant-app-basics/apptips.html
July 01, 2021 - Grant Application, Review & Award Process
Grant Application Basics
Application Forms … Funding
Grant Application, Review & Award Process
Grant Application Basics
Application Forms … Revision Application (when applicable)
1
Specific Aims (Attachment 2 on PHS 398 Research Plan form … DP7 applications only
25
Program Plan (Attachment 2 on PHS 398 Research Training Program Plan form … a multi-component application)
1
Specific Aims
For all Activity Codes that use an application form