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psnet.ahrq.gov/perspective/african-partnerships-patient-safety-lessons-learned
December 01, 2014 - same thing you've been trying to do which is give people the best quality care possible, but we're going … In some countries that's going to mean putting electronic health records in people's hands, giving them … It's just not going to happen, or not going to happen easily. … Now I see in many countries there's going to be a big global focus on what the international community … Every new hospital that they opened would start with discussions from the patients that were going to
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psnet.ahrq.gov/perspective/care-transitions
December 01, 2007 - system is having appropriate measurement in place so that we can actually judge whether things are going … EC: Most solutions are going to be local. … At each opportunity, the coach encourages the patient to speak up, even going as far as giving them the … Again, the coach isn't going to solve all the discrepancies, but the coach needs at least to be able … hospital team automatically make a whole series of assumptions about what that family member's role is going
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psnet.ahrq.gov/perspective/conversation-edward-kelley-phd
December 01, 2014 - same thing you've been trying to do which is give people the best quality care possible, but we're going … In some countries that's going to mean putting electronic health records in people's hands, giving them … It's just not going to happen, or not going to happen easily. … Now I see in many countries there's going to be a big global focus on what the international community … Every new hospital that they opened would start with discussions from the patients that were going to
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psnet.ahrq.gov/perspective/conversation-withthomas-h-gallagher-md
January 01, 2009 - If you're going to offer an apology, should it be an expression of regret ("I'm sorry about what happened … This is a shift we're going to see over the next few years—more and more disclosure being considered … It involves going in, quickly ascertaining what the patient knows about what's happened, and then, in … Then let the patient know we're going to look into this event carefully and we'll be back in touch to … We are going to do what it takes to make you better and make sure the same thing does not happen again
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psnet.ahrq.gov/issue/postoperative-opioid-prescribing-getting-it-rightt
August 20, 2018 - review discusses the development of the RIGHTT mnemonic (Risk for adverse event, Insight into pain, Going
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psnet.ahrq.gov/issue/three-laws-paperlessness
July 22, 2015 - The author outlines three laws to ensure safety when going paperless.
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psnet.ahrq.gov/issue/ers-are-swamped-seriously-ill-patients-although-many-dont-have-covid
November 01, 2023 - January 18, 2023
‘You’re going to release him when he was hurting himself?’
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psnet.ahrq.gov/node/33756/psn-pdf
October 01, 2013 - generally true, it is also true that the
benefits tend to plateau: after you reach a certain dose, going … RSB: You would think that if you're going to develop and promote higher dose multiphase studies that … There's some work
going on to engage physicians and patients in shared decision-making about imaging … We're going to be doing this to you and this could be causing
cancer as opposed to finding it. … But going forward all of us need to start doing this.
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psnet.ahrq.gov/issue/adverse-events-expecting-too-much-nurses-and-too-little-nursing-research
December 01, 2010 - November 12, 2014
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Related Resources
Going blank: factors
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psnet.ahrq.gov/node/73553/psn-pdf
July 28, 2021 - KH: For the quality assurance aspect of this, would that be you going back through and doing
audits … They
spent a little time talking with the patient and telling them what they thought might be going … simulations has been critically important and allows us to go through
circumstances that the providers are going … encounter very, very rarely—for example, childbirth, which is
not something that most EMS providers are going … Most providers are only going to see that once in their career.
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psnet.ahrq.gov/node/838222/psn-pdf
September 28, 2022 - practices and clinicians to
occasionally look out over the windowsill, open the door, and look at what’s going … What’s going on in the neighborhoods related
to education, employment, transportation, and housing, … I think when you say “patient safety,” oftentimes people hear “medical errors” and you’re
going to point … That’s what it gets down to—that if we’re going to work on behalf of our patients, we should be
leading … That’s a needle going into the skin that’s painful, but it’s not a
major life-threatening medical mistake
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psnet.ahrq.gov/node/33768/psn-pdf
June 01, 2014 - DdB: This is an area where people tend to have the idea that if we install the computer everything's going … exam room wall, so even when the
doctor is working on the computer they can be talking about what's going … How are we going to make those decisions? … think about the workload the system faces—if we
go into the visit with both parties knowing what's going
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psnet.ahrq.gov/node/33672/psn-pdf
September 01, 2008 - these barcodes before administration
has any impact, then even the best designed technology is not going … Getting good clinician buy-in that this technology is going to
work and partnering with a software vendor … that is capable of delivering something that fits into a clinician's
workflow obviously are going to … internally
developed system such as ours, we were able to reach the break-even point within about 1 year of going
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psnet.ahrq.gov/node/33662/psn-pdf
January 01, 2008 - The system had always had 25 or so people
who had been going out and working with the hospitals to ensure … Then we built the
transformation team approach, when we were going in and picking the top things that … absolutely randomized controlled trial evidence that a particular safety
intervention works just isn't going … For example, we're not going to do a randomized trial of washing your hands.
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psnet.ahrq.gov/node/33670/psn-pdf
July 01, 2008 - analysis and it was consuming all of their time, and they were not sure
in the end what the result was going … to be—whether it was going to actually help their institution to improve
quality or safety. … then use experts in
patient safety to look at what may be a signal and to help interpret what's going … individual hospitals
and groups of hospitals and hospital systems, where they exist, should track what's going
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psnet.ahrq.gov/perspective/evolution-root-cause-analysis
February 26, 2025 - At the same time, if we have leaders who are punitive in their response to events, we are not going to … At the same time, when we go out and interview staff in those organizations, they are not going to tell … We have individuals going out into individual homes, where some serious events occur, like patient falls … As a patient safety manager, it’s not the right approach to say “I’m going to change the way that we … do root cause analysis, but I’m not going to talk to the risk management staff because they probably
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psnet.ahrq.gov/perspective/conversation-timothy-vogus-about-high-reliability-organization-hro-principles-and
February 26, 2025 - Do we have ways to check if we are going off the rails built into the process? … Not every organization is going to have that kind of leader. … We looked at implementations of high reliability in a system that did not go great , but in not going … Tim Vogus: I am not going to give big, sweeping pronouncements here because of the limitations we talked … will scale up to being a highly reliable hospital,” we have to work on how we are going to marshal tools
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psnet.ahrq.gov/perspective/conversation-jessica-behrhorst-about-evolution-root-cause-analysis
February 26, 2025 - At the same time, if we have leaders who are punitive in their response to events, we are not going to … At the same time, when we go out and interview staff in those organizations, they are not going to tell … We have individuals going out into individual homes, where some serious events occur, like patient falls … As a patient safety manager, it’s not the right approach to say “I’m going to change the way that we … do root cause analysis, but I’m not going to talk to the risk management staff because they probably
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psnet.ahrq.gov/perspective/high-reliability-organization-hro-principles-and-patient-safety
February 26, 2025 - Do we have ways to check if we are going off the rails built into the process? … Not every organization is going to have that kind of leader. … We looked at implementations of high reliability in a system that did not go great , but in not going … Tim Vogus: I am not going to give big, sweeping pronouncements here because of the limitations we talked … will scale up to being a highly reliable hospital,” we have to work on how we are going to marshal tools
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psnet.ahrq.gov/issue/think-health-care-workers-are-tested-often-coronavirus-think-again
July 29, 2020 - July 15, 2020
A nursing home’s 64-day Covid siege: ‘They’re all going to die’.