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psnet.ahrq.gov/sites/default/files/import/webmm.ahrq.gov.188_slideshow.ppt
November 01, 2008 - Joint Commission on Accreditation of Healthcare Organizations. 2007 National Patient Safety Goals. … Joint Commission on Accreditation of Healthcare Organizations. 2007 National Patient Safety Goals. … L: Sacrifices to safety goals to meet economic and production goals are common occurrences not usually … People adapt procedures over time in response to feedback
L: Policies heavily slanted toward safety goals … explore applying desired trade-off weightings across a range of routine and exceptional cases because a goal
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psnet.ahrq.gov/node/41211/psn-pdf
January 03, 2017 - standardized processes for avoiding patient misidentification as one of the National Patient Safety Goals … organizational-change-face-highly-public-errors-ii-duke-experience
https://psnet.ahrq.gov/issue/national-patient-safety-goals
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psnet.ahrq.gov/node/39249/psn-pdf
September 30, 2015 - patient-participation-current-knowledge-and-applicability-patient-safety
Engaging patients in safety efforts is required as one of the National Patient Safety Goals … patient-participation-current-knowledge-and-applicability-patient-safety
https://psnet.ahrq.gov/issue/national-patient-safety-goals
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psnet.ahrq.gov/issue/national-patient-safety-goal-improve-health-care-equity
September 11, 2019 - Newspaper/Magazine Article
National patient safety goal to improve health care equity … Citation Text:
National patient safety goal to improve health care equity. R3 Report. … shares the Joint Commission strategy for embedding equity improvement into the National Patient Safety Goal … Cite
Citation
Citation Text:
National patient safety goal
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psnet.ahrq.gov/node/36380/psn-pdf
February 28, 2011 - diagnosis and treatment to poor communication and handoffs (the latter is a 2007 National Patient Safety
Goal … graduate-medical-education-and-patient-safety-busy-and-occasionally-hazardous-intersection
https://psnet.ahrq.gov/issue/national-patient-safety-goals … https://psnet.ahrq.gov/issue/national-patient-safety-goals
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psnet.ahrq.gov/node/40502/psn-pdf
January 01, 2020 - New 2012 National Patient Safety Goal - catheter-
associated urinary tract infection (CAUTI). … https://psnet.ahrq.gov/issue/new-2012-national-patient-safety-goal-catheter-associated-urinary-tract- … infection-cauti
This announcement reveals the new National Patient Safety Goal for 2012, which aims … https://psnet.ahrq.gov/issue/new-2012-national-patient-safety-goal-catheter-associated-urinary-tract-infection-cauti … https://psnet.ahrq.gov/issue/national-patient-safety-goals
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psnet.ahrq.gov/node/38558/psn-pdf
February 18, 2011 - medication
reconciliation for long-term care facilities as part of the 2009 National Patient Safety Goals … psnet.ahrq.gov/primer/medication-reconciliation
https://psnet.ahrq.gov/issue/national-patient-safety-goals
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psnet.ahrq.gov/node/39002/psn-pdf
January 03, 2017 - importance of patient engagement was elevated
by its introduction into the National Patient Safety Goals … health-care-consumers-inclination-engage-selected-patient-safety-practices-survey-adults
https://psnet.ahrq.gov/issue/national-patient-safety-goals
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psnet.ahrq.gov/web-mm/culture-clash-no-more-integration-and-coordination-disease-treatment-and-palliative-care
December 23, 2020 - The patient declined any surgical intervention or chemotherapy after discussing goals of care with an … Further discussions of the goals of care revealed that the patient desired to focus on comfort and on … inpatient hospice team discussed the potential role of brain radiotherapy for palliation to meet the goal … The visionary goal of this regulation was to eliminate family concerns about costs related to medications … While preventing complications remains part of patient safety, preventing death is no longer a safety goal
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psnet.ahrq.gov/node/39405/psn-pdf
March 31, 2010 - Overcrowding was one factor cited as a major barrier to implementing the
National Patient Safety Goals … barriers-emergency-departments-adherence-four-medication-safety-related-joint-commission
https://psnet.ahrq.gov/issue/national-patient-safety-goals
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psnet.ahrq.gov/node/44847/psn-pdf
May 09, 2017 - hospital discharge, insufficient
communication with outpatient providers, failure to discuss care goals … deficits-communication-and-information-transfer-between-hospital-based-and-primary-care
https://psnet.ahrq.gov/issue/avoiding-iatrogenic-harm-patient-and-family-while-discussing-goals-care-near-end-life
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psnet.ahrq.gov/issue/emergency-physician-perceptions-patient-safety-risks
September 15, 2011 - specialists, there are noted barriers to adopting The Joint Commission's National Patient Safety Goals … providers from diverse practice settings to illustrate the disconnect between nationally stated safety goals
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psnet.ahrq.gov/taxonomy/term/3440
December 09, 2024 - stress among team members (including oneself), environmental threats to safety, appropriate immediate goals
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psnet.ahrq.gov/issue/sustaining-improvement
January 09, 2019 - November 11, 2020
Health care quality and safety in a correctional system: creating goals … November 26, 2013
Meeting the Joint Commission's 2013 National Patient Safety Goals.
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psnet.ahrq.gov/node/39176/psn-pdf
December 16, 2009 - maintain a
system for rapid evaluation of unstable patients as one of the National Patient Safety Goals … relationship-between-early-emergency-team-calls-and-serious-adverse-events
https://psnet.ahrq.gov/issue/national-patient-safety-goals
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psnet.ahrq.gov/node/33584/psn-pdf
March 15, 2025 - Approaches to improving communication between clinicians share common goals, but differ depending on … The Joint Commission includes "improving staff communication" as one of its National Patient Safety Goals … teamwork-training
https://psnet.ahrq.gov/issue/cusp-toolkit
https://psnet.ahrq.gov/issue/national-patient-safety-goals
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psnet.ahrq.gov/node/844055/psn-pdf
February 08, 2023 - National patient safety goal to improve health care equity.
February 8, 2023
R3 Report. … https://psnet.ahrq.gov/issue/national-patient-safety-goal-improve-health-care-equity
Health care inequities … shares the Joint Commission strategy for embedding equity improvement
into the National Patient Safety Goal … https://psnet.ahrq.gov/issue/national-patient-safety-goal-improve-health-care-equity
https://psnet.ahrq.gov … achieving-zero-inequity-lessons-learned-patient-safety
https://psnet.ahrq.gov/issue/national-patient-safety-goals
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psnet.ahrq.gov/node/43224/psn-pdf
June 11, 2014 - mandates that hospitals
have systems for preventing these errors as part of its National Patient Safety Goals … psnet.ahrq.gov/issue/ismps-list-confused-drug-names
https://psnet.ahrq.gov/issue/national-patient-safety-goals
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psnet.ahrq.gov/node/39566/psn-pdf
January 03, 2017 - conducted in a surgical inpatient unit at an academic hospital,
included implementation of a daily goals … reporting-patient-safety-events
https://psnet.ahrq.gov/issue/improving-communication-icu-using-daily-goals
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psnet.ahrq.gov/sites/default/files/2019-12/spotlight_code_status_dec_2019_powerpoint.pdf
January 01, 2019 - )
16
Systems Approach to Improving Safety
• Appropriate training and supervision around ACP or goals-of-care … new code status could prevent an adverse event
20
Take-Home Points
• Code status discussions, “goals-of-care … to obtain a code status for
patients that includes their individual preferences, surrogates, and
goals … Vital Talk: Address Goals of Care. … Accessed Nov 2019 via the Web at https://www.vitaltalk.org/topics/reset-
goals-of-care/
13.