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Showing results for "happen".

241. Slide 1 (ppt file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/cusptoolkit/toolkit/contentcalls/briefing-slides/Morning-Briefing-and-Shadowing-July-12-2011-508.ppt
     January 01, 2011 - -- An Overview Members of the team have an understanding of what’s going on and what is likely to happen … procedure Establishes competence Who has what skills Who performs what Who knows what Predicts what will happen

242. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/36219/psn-pdf
     October 18, 2010 - psnet.ahrq.gov/issue/risk-society-and-system-failure The author discusses why large scale accidents happen

243. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/35181/psn-pdf
     June 23, 2009 - Communication during trauma resuscitation: do we know what is happening? June 23, 2009 Bergs EAG, Rutten FLPA, Tadros T, et al. Communication during trauma resuscitation: do we know what is happening? Injury. 2005;36(8):905-11. https://psnet.ahrq.gov/issue/communication-during-trauma-resuscitation-do-we-know-what-…

244. In Conversation with...Albert Wu, MD, MPH | PSNet
     psnet.ahrq.gov/perspective/conversation-withalbert-wu-md-mph
     February 26, 2025 - What then needs to happen is the institutions need to track what the solutions are, and they need to … serious incidents, called sentinel events, and any hospital board would like to see these things never happen … Wrong site surgeries are a pretty good example of this—they happen to every big institution a few times

245. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/49468/psn-pdf
     December 16, 2004 - most sophisticated operating theaters and in the hands of highly trained surgeons—can such things happen … Or, in this case, almost happen? … Good systems do not just happen.

246. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/33688/psn-pdf
     October 01, 2009 - As you start reading through these forms, you start seeing the range of things that happen in health … out, but generally the institution did not make an effort to cover it up or to try to say it didn't happen … Part of the job of the media is not only to explain when these events happen but to try to put them … So I think it's an excuse to try to say that it's just the media attention, that these problems happen … Is the goal to make it better or at some point do you just say this is not going to happen?

247. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/44359/psn-pdf
     January 06, 2016 - What happens when healthcare innovations collide? January 6, 2016 Pendharkar SR, Woiceshyn J, da Silveira GJC, et al. What happens when healthcare innovations collide? BMJ Qual Saf. 2016;25(1):9-13. doi:10.1136/bmjqs-2015-004441. https://psnet.ahrq.gov/issue/what-happens-when-healthcare-innovations-collide Innovat…

248. Introduction | Agency for Healthcare Research and Quality
     www.ahrq.gov/ncepcr/tools/obesity/obpcp-intro.html
     May 01, 2014 - What didn't happen? There was no discussion of diet and nutrition as part of Ms. … Why didn't it happen?

249. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/47944/psn-pdf
     April 17, 2019 - how-deliver-safer-and-effective-patient-care-tips-team-leaders-and-educators https://psnet.ahrq.gov/issue/adverse-outcomes-why-bad-things-happen-good-people

250. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/866746/psn-pdf
     September 18, 2024 - https://psnet.ahrq.gov/primer/leadership-role-improving-safety https://psnet.ahrq.gov/issue/could-it-happen-here-learning-other-organizations-safety-errors

251. Coaching Clinical Teams Module | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/tools/ambulatory-surgery/sections/implementation/training-tools/coaching-slides.html
     May 01, 2017 - "Can you help me understand why that didn't happen?

252. Module 3: Conversations Around Device Necessity | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/cauti-tools/cauti-icu/facil-guide/mod3-slides.html
     February 01, 2023 - Slide 5 What Do You Think Will Happen? Images: Photo of "Nurse Sally" and "Nurse Molly."

253. Tool: I-PASS | Agency for Healthcare Research and Quality
     www.ahrq.gov/teamstepps-program/curriculum/communication/tools/ipass.html
     July 01, 2023 - ownership S ituation Awareness & Contingency Planning Know what's going on Plan for what might happen

254. Did You Know, Safety Infographic (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/resources/diagnostic-toolkit/03-diagnostic-safety-infographic.pdf
     August 01, 2021 - Did You Know, Safety Infographic Did you know... 57% of all diagnostic failures happen in ambulatory

255. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/844987/psn-pdf
     February 22, 2023 - examining-medication-ordering-errors-using-ahrq-network-patient-safety- databases Medication errors can happen

256. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/841481/psn-pdf
     January 01, 2023 - trainees-perceptions-being-allowed-fail-clinical-training-sense-making-model https://psnet.ahrq.gov/issue/surgical-errors-happen-are-learners-trained-recover-them-survey-north-american-surgical

257. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/50922/psn-pdf
     February 19, 2020 - organisation-memory-report-expert-group-learning-adverse-events-nhs-chaired-chief-medical https://psnet.ahrq.gov/issue/could-it-happen-here-learning-other-organizations-safety-errors

258. Event Investigation and Analysis Guide: Appendix D | Agency for Healthcare Research and Quality
     www.ahrq.gov/patient-safety/settings/hospital/candor/modules/guide4/apd.html
     August 01, 2022 - FUTURE RISKS Are there other areas in the organization where this could happen?      

259. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/33710/psn-pdf
     May 01, 2011 - There has been some survey research, and an unsurprising finding is that after these things happen, … We really feel bad when bad things happen. We all want to behave like human beings. … I think it's because we have such a disbelief that these things happen that when something really goes

260. Overview of the Comprehensive Unit-based Safety Program for Application to Mechanically Ventilated Patients: Facilitator Guide | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/tools/mvp/modules/cusp/overview-cusp-mvp-facguide.html
     February 01, 2017 - Say: A defect is anything that can happen clinically or operationally that you do not want to have … happen again. … First ask, how did the defect happen?