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81. Module 18: Assessing Practice Readiness for Change (pdf file)
    pcmh.ahrq.gov/sites/default/files/attachments/pcpf-module-18-assessing-readiness.pdf
    September 01, 2015 - Because they lack the basic administrative and clinical systems needed to function effectively, the form … Sample data inventory form Department: Date: Information being collected (Summary – Optional … (Patient completes form, verbal question by receptionist, etc.) … EXAMPLE: Diabetes lab data, PHQ 9 data, visit data Manual entry from PHQ 9 forms; auto input … American Asian American Indian Entered from information provided by patient on “first visit form

82. Timeframe for Application Preparation | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/funding/process/grant-app-basics/apptime.html
    October 01, 2014 - Funding Grant Application, Review & Award Process Grant Application Basics Application Forms … Writing Phase Prepare outline following the application framework and structure described in the Form … Make sure all check box items on the face page of the Form PHS 398 are completed.

83. Development and Usability Testing of the Agency for Healthcare Research and Quality Common Formats to Capture Diagnostic Safety Events (pdf file)
    pcmh.ahrq.gov/sites/default/files/wysiwyg/topics/development-and-usability-testing-common-formats.pdf
    January 01, 2022 - •The form was restructured to allow respondents to report details of several interrelated diagnostic … Suggestions for revising the form included having separate sets of items (e.g., using branching logic … ) or separate forms for inpa- tient versus outpatient settings. … There was no consensus about who in the organization should complete the form, and some participants … One participant noted that prior review “made it a lot easier” to complete the form.

84. Your Guide to Preventing and Treating Blood Clots | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/patients-consumers/prevention/disease/bloodclots.html
    August 01, 2017 - Return to Contents Causes of Blood Clots Blood clots can form if you don't move around a lot. … Blood clots that form in the veins in your legs, arms, and groin can break loose and move to other parts … heparin Types of medicines that keep blood from clotting Deep vein thrombosis A blood clot that forms … Below the drawing is the text: "Blood clots can form in any deep veins of the body. … Most often they form in the legs, arms, or groin."

85. TeamSTEPPS 2.0 Fundamentals | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/teamstepps/instructor/fundamentals/index.html
    June 01, 2019 - Instructor's Guide ( PDF File , 465 KB) Classroom Slides ( PowerPoint® File , 1.47 MB) Coaching Feedback Form … Instructor's Guide ( PDF File , 147 KB) Classroom Slides ( PowerPoint® File, 455 KB) Teaching Feedback Form

86. Implementation Quick Start Guide: Teach-Back (pdf file)
    pcmh.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/teach-back-quickstart-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

87. TeamSTEPPS 2.0: Module 10. Measurement | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/teamstepps/instructor/fundamentals/module10/igmeasure.html
    March 01, 2014 - Reactions —TeamSTEPPS Course Evaluation Form. … Return to Contents Reactions: TeamSTEPPS Course Evaluation Form Say: Participant reactions … A customizable TeamSTEPPS Course Evaluation Form for assessing participant reactions can be found in … This form captures both affective and instrumentality reactions. … patient safety culture has an accompanying toolkit that contains the following materials: Survey forms

88. Implementation Quick Start Guide: Create a Safe Medicine List Together (pdf file)
    pcmh.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/medicinelist-quickstart-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

89. Delivering Quality Reports in Print | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/talkingquality/distribute/media/printed-report.html
    September 01, 2019 - Printed reports typically take the form of stand-alone documents. … Several quality reports designed for Medicaid audiences, for example, take the form of brief brochures

90. Four Moments of Antibiotic Decision Making | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/antibiotic-use/acute-care/four-moments/index.html
    November 01, 2019 - Team Antibiotic Review Form The Antibiotic Stewardship Program is encouraged to find time to meet … portion of patients receiving antibiotics; this can be guided by use of the Team Antibiotic Review Form

91. Medication Management: Common Barriers to Medication Adherence (pdf file)
    pcmh.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-family-engagement/pfeprimarycare/medication-mgmt-common-barriers-full.pdf
    January 11, 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

92. Patient Safety Organizations: A Summary of 2014 Profiles (pdf file)
    pcmh.ahrq.gov/sites/default/files/wysiwyg/npsd/npsd-portfolios-summary-profile-2014.pdf
    January 01, 2014 - PSOs are asked to complete the PSO Profile Form annually to provide additional detail on the PSO program … The PSO Profile Form provides retrospective information about a PSO’s operations, and the numbers and … , Patient Information Form, and Summary of Initial Report Form) and then applying Common Formats for … Levigate with a small amount of base solution to form a paste. 4. … Accessed February 8, 2016. 8 Conclusion The PSO Profile Form information presented in this brief

93. Coaching Workshop: Classroom Slides | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/teamstepps/lep/coaching/lepslcoaching.html
    December 01, 2012 - to Contents Slide 12: Exercise: Coaching Self-Assessment Complete a coaching self-assessment form … Participants review the scenarios and Coaching Feedback Form. … The observer completes the Coaching Feedback Form and shares it with the groups.

94. Preventing Falls in Hospitals (Slide Presentation) | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/patient-safety/settings/hospital/fall-prevention/webinar/slides.html
    June 01, 2018 - Self-assessment + follow-up phone call In-person meeting + monthly teleconferences Tool evaluation forms … Slide 13 Tool: Interdisciplinary Team (2A) Part I: Team Members Image of tool to list in table form … Interdisciplinary Team (2A) Part 3: Matrix of Applicable Tools by Role Image of tool to list in matrix form … Improvement Objective: Implement standard fall prevention practices within 6 months Image of tool in table form

95. Sustaining Stewardship Activities | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/antibiotic-use/acute-care/improve/sustain.html
    November 01, 2019 - Stewardship Bedside Nurse Collaborate With Microbiology Lab Team Antibiotic Review Form

96. AHRQ Grants for Health Services Research Dissertation Program (R36) | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/funding/training-grants/r36.html
    November 01, 2023 - peer-reviewed journal(s) by submitting the Get Recognition for Your AHRQ-Funded Study fillable PDF form … Please email the completed form to journalpublishing@ahrq.hhs.gov , with a copy to your Program Official

97. The Role of the Bedside Nurse in Antibiotic Stewardship Interventions | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/antibiotic-use/acute-care/improve/bedside-nurse.html
    November 01, 2019 - Stewardship Bedside Nurse Collaborate With Microbiology Lab Team Antibiotic Review Form

98. Improving Communication and Teamwork Around Antibiotic Decision Making | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/antibiotic-use/acute-care/safety/communication.html
    November 01, 2019 - Antibiotic Decision Making framework Slides (PPTX) Facilitator Guide (PDF) Team Antibiotic Review Form

99. Making Effective Behavior Changes Around Antibiotic Prescribing | Agency for Healthcare Research and Quality
    pcmh.ahrq.gov/antibiotic-use/acute-care/improve/behavior-changes.html
    November 01, 2019 - Stewardship Bedside Nurse Collaborate With Microbiology Lab Team Antibiotic Review Form

100. TeamSTEPPS Rapid Response Systems Module | Agency for Healthcare Research and Quality
     pcmh.ahrq.gov/teamstepps/rrs/rrsspecscen.html
     October 01, 2014 - Response team members and the nurse who called the team completed a Call Evaluation Form. … The patient’s nurse noted on the form that the response team seemed agitated by the lack of supplies … The evaluation forms were sent via interdepartmental mail to the quality department as indicated on the … form. … The forms were not collated or reviewed for several weeks.