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81. Appendix B9: FMP Entry Log | Agency for Healthcare Research and Quality
    www.ahrq.gov/patient-safety/settings/long-term-care/resource/injuries/fallspx/manapb09log.html
    February 01, 2023 - Forms and Training Materials (Appendix Contents) Appendix C.

82. Final Progress Report: SAFER: Standardizing Admissions for Elderly residents (pdf file)
    www.ahrq.gov/sites/default/files/2024-01/coburn-report.pdf
    January 01, 2024 - Maine Quality Forum Collaborative of Stakeholders •Develop universal standardized transfer form and … The research team provided a chart review tracking form (Figure B) to the hospital project leads for … The original proposal included the development of a universal transfer form. … Patient transfer forms enhance key information between nursing homes and emergency department. … An extended care facility-to-emergency department transfer form improves communication.

83. Measure: Initial Risk Assessment for Immobility-Related Pressure Ulcer Within 24 Hours of Pediatric Intensive Care Unit (PICU) Admission (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/chipra-16-p002-1-ef.pdf
    May 01, 2016 - One site performed parallel-forms testing and compared the construction of this eMeasure against manual … periods January 1 – June 30, 2015 and July 1 – December 31, 2015. 3 The site performing parallel-forms … chart review measure was high, with 98 percent of patients meeting the measure. 4 ● In parallel-forms … ● In parallel-forms reliability testing of the chart review measure, the clinical performance was

84. Appendix B1: The Falls Management Program Self-Assessment Tool | Agency for Healthcare Research and Quality
    www.ahrq.gov/patient-safety/settings/long-term-care/resource/injuries/fallspx/manapb1.html
    February 01, 2023 - Forms and Training Materials (Appendix Contents) Appendix C.

85. Appendix B2: Tracking Record for Improving Patient Safety (TRIPS) | Agency for Healthcare Research and Quality
    www.ahrq.gov/patient-safety/settings/long-term-care/resource/injuries/fallspx/manapb-2.html
    February 01, 2023 - Forms and Training Materials (Appendix Contents) Appendix C.

86. Appendix B7: Wheelchair Seating Assessment | Agency for Healthcare Research and Quality
    www.ahrq.gov/patient-safety/settings/long-term-care/resource/injuries/fallspx/manapb4.html
    February 01, 2023 - Forms and Training Materials (Appendix Contents) Appendix C.

87. Guide for Developing a Community-Based Patient Safety Advisory Council | Agency for Healthcare Research and Quality
    www.ahrq.gov/research/findings/final-reports/advisorycouncil/adcouncilapi.html
    April 01, 2018 - Evaluation forms completed by council members after each meeting. B. … Evaluation forms completed by council members after each meeting.

88. Appendix B10: Primary Care Provider Fax Report and Orders | Agency for Healthcare Research and Quality
    www.ahrq.gov/patient-safety/settings/long-term-care/resource/injuries/fallspx/manapb10pcp.html
    February 01, 2023 - Forms and Training Materials (Appendix Contents) Appendix C.

89. 2. Description of the Intervention (continued) | Agency for Healthcare Research and Quality
    www.ahrq.gov/research/findings/final-reports/crcscreeningrpt/crcscreen2a.html
    April 01, 2018 - ideally involves two components: (1) conducting electronic record reviews, and (2) reviewing returned SEA forms … We also allowed more time for receiving completed forms. … Our Experience We sent the appropriate feedback forms to the practices at several interim points during … However, we did not receive any completed forms. … We contacted the practice manager at several points regarding collecting the CDE feedback forms without

90. Term of Award: Trafficking in Persons | Agency for Healthcare Research and Quality
    www.ahrq.gov/funding/grant-mgmt/trafficking.html
    October 01, 2014 - employees, subrecipients under this award, and subrecipients' employees may not— Engage in severe forms … "Severe forms of trafficking in persons," "commercial sex act," and "coercion" have the meanings given

91. An Update on the CAHPS Patient Narrative Item Sets - Schlesinger (pdf file)
    www.ahrq.gov/sites/default/files/wysiwyg/cahps/news-and-events/events/webinars/cahps-patient-narrative-schlesinger.pdf
    June 02, 2025 - testing  NIS wording: Still underway 21 The Health Plan Narrative Item Set: Yield ► THREE distinct forms … questions Beyond domains of closed-ended questions 22 The Health Plan Narrative Item Set: Yield • Forms

92. 204. Specific Populations and Other Topics (Continued) | Agency for Healthcare Research and Quality
    www.ahrq.gov/prevention/guidelines/tobacco/clinicians/presentations/2008update-full/slide204.html
    October 01, 2014 - (Strength of Evidence = A) Recommendation: Users of cigars, pipes, and other noncigarette forms of

93. Appendix 1-B. Trademarks | Agency for Healthcare Research and Quality
    www.ahrq.gov/research/publications/pubcomguide/pcguide1apb.html
    April 01, 2024 - Release Forms Appendix 1-B. Trademarks Appendix 1-C.

94. Section 1: Product Development | Agency for Healthcare Research and Quality
    www.ahrq.gov/research/publications/pubcomguide/pcguide1.html
    March 01, 2025 - Release Forms Appendix 1-B. Trademarks Appendix 1-C. … Permission Forms Appendix 1-B. Trademarks Appendix 1-C. … following statement is used if a Federal employment option is not provided on the journal's copyright form … Appendix 1-A provides a permission form  (PDF, 575 KB) to request use of copyrighted items. … 1320b-10): "2(B) No person may, for a fee, reproduce, reprint, or distribute any item consisting of a form

95. Appendix 1-C. YouTube Submission Checklist | Agency for Healthcare Research and Quality
    www.ahrq.gov/research/publications/pubcomguide/pcguide1apc.html
    March 01, 2025 - Release Forms Appendix 1-B. Trademarks Appendix 1-C.

96. EvidenceNOW: Data Submission Form | Agency for Healthcare Research and Quality
    www.ahrq.gov/evidencenow/projects/heart-health/research-results/research/submission-form-mw.html
    March 01, 2021 - EvidenceNOW: Data Submission Form Midwest Cooperative Resource: Chart Review: Submission for … Baseline, 12, & 18 Months (PDF, 148 KB, 2 pages) This data submission form was used by an EvidenceNOW

97. EvidenceNOW: Data Submission Form | Agency for Healthcare Research and Quality
    www.ahrq.gov/evidencenow/projects/heart-health/research-results/research/submission-form-nw.html
    March 01, 2021 - EvidenceNOW: Data Submission Form Northwest Cooperative Resource: Blood Pressure Chart Abstraction … Protocol and Timeline (PDF, 118.25 KB, 2 pages) This data submission form was used by an EvidenceNOW

98. EvidenceNOW: Implementation Tracking Form | Agency for Healthcare Research and Quality
    www.ahrq.gov/evidencenow/projects/heart-health/research-results/research/implementation-tracking-sw.html
    March 01, 2021 - EvidenceNOW: Implementation Tracking Form Southwest Cooperative Resource: Implementation … Tracking Note—Southwest Cooperative (PDF, 363.33 KB, 2 pages) This intervention tracking form used

99. Appendix C6: Falls Assessment Report Sample | Agency for Healthcare Research and Quality
    www.ahrq.gov/patient-safety/settings/long-term-care/resource/injuries/fallspx/apcfigtxt6.html
    December 01, 2017 - Forms and Training Materials (Appendix Contents) Appendix C. … Falls Engineer Instructions Note: This form has been filled out with information for

100. Strategies for Improving Patient Experience with Ambulatory Care: Cultivating Cultural Competence (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/cahps/quality-improvement/improvement-guide/6-strategies-for-improving/communication/cahps-strategy-6k.pdf
     August 01, 2017 - • The availability of health plan forms in the respondent’s preferred language. … • The availability of health plan forms in a needed format, such as large print or braille. … health plans should collect information on race, ethnicity, and preferred language through standard forms … These forms should be available in multiple languages and explain why the information is being collected—i.e … Cultivating Cultural Competence August 2017 6.K-3  Collects information from Medicaid application forms