-
www.ahrq.gov/news/newsroom/case-studies/201514.html
June 01, 2015 - We want our patients to understand our answers to their typical questions, such as ‘What's going to happen
-
www.ahrq.gov/hai/tools/surgery/guide-surg-comp.html
December 01, 2017 - Identification and Mitigation Tool ( Word , 1.73 MB)
Understand where, when, and why workarounds happen
-
www.ahrq.gov/patient-safety/settings/hospital/candor/modules/notes4.html
August 01, 2022 - and Analysis is that managing individual performance alone does not ensure that a harm event won't happen
-
www.ahrq.gov/sites/default/files/wysiwyg/cahps/news-and-events/events/webinars/hcbs-2021-webcast-ahrq.pdf
January 01, 2021 - Introducing a New Database for Users of the CAHPS Home and Community-Based Services (HCBS CAHPS) Survey - GINSBERG
AHRQ’S CAHPS® PROGRAM
Caren Ginsberg, Ph.D., CPXP
Director, CAHPS and Surveys on Patient Safety Culture
(SOPS) Programs
Center for Quality Improvement & Patient Safety, AHRQ
6
7
AHRQ’s Core Compe…
-
www.ahrq.gov/patient-safety/settings/long-term-care/resource/injuries/fallspx/man5.html
December 01, 2017 - Inservices for All Facility Staff
Goals and objectives of class
The goals of Inservice #1, " Why Falls Happen … There is one handout for inservice #1, Why Falls Happen , and one handout for inservice #2, How to … Handout for inservice #1, Why Falls Happen , a copy for each participant.
-
www.ahrq.gov/talkingquality/distribute/promote/multiple/advertise.html
September 01, 2019 - Recommended resource: Why Bad Ads Happen to Good Causes .
-
www.ahrq.gov/sites/default/files/wysiwyg/sops/databases/medical-office/2016-report-part-2.pdf
January 01, 2016 - They overlook patient care mistakes that happen over and over. … Mistakes happen more than they should in this office. (F3R) 80% 82%
3. … Mistakes happen more than they should in this office. … They overlook patient care mistakes that happen over and over. … They overlook patient care mistakes that happen over and over.
-
www.ahrq.gov/cahps/news-and-events/podcasts/ginsberg-podcast.html
September 01, 2016 - all of the questions in CAHPS surveys ask whether or how often the things that are supposed to happen … , like quick access to care and good communication with providers, actually did happen.
-
www.ahrq.gov/hai/tools/mvp/modules/cusp/science-of-safety-fac-guide.html
February 01, 2017 - Slide 5: Errors Happen Because…
Say:
Errors happen because people are fallible.
-
www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa-2/003-ss-antimicrobial-prophylaxis-part-2-fg.docx
April 01, 2025 - Why did it happen? How can you reduce the likelihood of this defect from happening again? … Slide 37
Case Example: Why Did It Happen?
SAY:
Why did this happen?
-
www.ahrq.gov/hai/cauti-tools/cauti-icu/facil-guide/mod3.html
February 01, 2023 - Does anything like this happen in his/her facility?
Slide 3: Is This the Right Call?
… Slide 5: What Do You Think Will Happen?
-
www.ahrq.gov/patient-safety/settings/hospital/candor/grand-rounds.html
August 01, 2022 - physician, and/or care provider to be fully transparent when an error occurs, but often this doesn't happen … It is important to understand that communication doesn't happen just once and then you are done; rather
-
www.ahrq.gov/patient-safety/settings/hospital/candor/modules/notes6.html
August 01, 2022 - The second-victim is often fearful at this point about what is going to happen next and whether or not … clinical staff involved in the event, notify clinical staff involved in the event what is going to happen
-
www.ahrq.gov/patient-safety/settings/long-term-care/resource/facilities/ltc/mod3concl.html
October 01, 2014 - Pitfalls
Not having a falls assessment for a resident is like allowing an "accident waiting to happen
-
www.ahrq.gov/sites/default/files/wysiwyg/cahps/news-and-events/events/webinars/cahps-101-webcast-03-fry.pdf
June 02, 2025 - CAHPS 101
WHAT IS PATIENT EXPERIENCE
AND HOW DOES CAHPS
MEASURE IT?
Stephanie Fry
Senior Study Director
Westat
What is Patient Experience?
Patient experience encompasses the range of interactions that
patients have with the health care system, including:
13
Coordinated care
from doctors and
nurses in he…
-
www.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/nursing-home/workplace-safety-items-english.pdf
September 01, 2024 - 4 5 9
Section B: Moving, Transferring, or Lifting Residents
How often do the following things happen … 1 2 3 4 5 9
Section D: Interactions Among Staff
How often do the following things happen
-
www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/empower-staff-transcript.pdf
April 01, 2022 - Kate: So, imagine that you're coaching one on one with a timid nurse, and they
happen to be working … receiving feedback from somebody else who has decided to speak up so that we
encourage that behavior to happen
-
www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/safety/changes-slides.pptx
November 01, 2019 - Why did it happen?
How will you reduce the risk of the adverse event from happening again?
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/implementation/long-term-modules/module4/facilitator-notes.docx
March 01, 2017 - Include resident/family responsibilities for care
N Next—What will happen next? … CUS can be used as one way to “Stop the line” when something unsafe is about to happen to a resident.
-
www.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/medical-office/2024-medical-office-database-report-appendix.pdf
January 01, 2024 - (Item E1*) 45% 49% 47% 47% 41% 43%
They overlook patient care mistakes that happen over and over. … (Item E1*) 46% 44%
They overlook patient care mistakes that happen over and over. … (Item E1*) 48% 44% 49% 35%
They overlook patient care mistakes that happen over and over. … (Item E1*) 45% 47% 46% 28%
They overlook patient care mistakes that happen over and over. … (Item E1*) 56% 47% 42% 43% 46%
They overlook patient care mistakes that happen over and over.