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Total Results: 4,088 records

Showing results for "happen".

2581. Implementing the SPPC‐II Teamwork Toolkit (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/perinatal-care-2/hypertension_7-implementation-speaker-notes.pdf
      July 01, 2023 - • Asking frontline staff, "What bad outcomes are waiting to happen because of breakdowns in the transfer … you collectively brainstorm to identify as many potential local barriers to your success before they happen

2582. CHCANYS Participation Guide (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/evidencenow/tools-and-materials/chcanys-qi-primer.pdf
      August 01, 2017 -  Plan – In this phase, your objectives are defined and your team makes predictions about what will happen … , and why it will happen.

2583. Implementing the SPPC-II Teamwork Toolkit (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/perinatal-care-2/hemorrhage_7-implementation-speaker-notes.pdf
      July 01, 2023 - • Asking frontline staff, "What bad outcomes are waiting to happen because of breakdowns in the transfer … you collectively brainstorm to identify as many potential local barriers to your success before they happen

2584. What Do We Know About Emergency Department Safety? | PSNet
      psnet.ahrq.gov/perspective/what-do-we-know-about-emergency-department-safety
      June 01, 2010 - What about you and your background caused that to happen? … And you can watch them happen: You can just stand back sometimes and admire the cognitive choreography

2585. The Rationale for Case Mix and Mode Adjustments - Elliott (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/cahps/news-and-events/events/webinars/3-case-mix-mode-adjustments-webcast-elliott.pdf
      June 02, 2025 - same hospitals 32 The Effect of Adjustments • Mode adjustments can be substantial because they happen

2586. Treating Disruptive Behavior Disorders in Children and Teens (pdf file)
      effectivehealthcare.ahrq.gov/sites/default/files/pdf/disruptive-behavior-disorder_consumer.pdf
      August 01, 2016 - Outbursts happen with little or no warning. They usually last for 30 minutes or less.

2587. Ventricular Wall Injury during a Diagnostic Cardiac Catheterization | PSNet
      psnet.ahrq.gov/web-mm/ventricular-wall-injury-during-diagnostic-cardiac-catheterization
      September 01, 2012 - Ultimately, this case is an excellent example of what can happen when best practices are not followed

2588. Wrong Turn through Colon: Misplaced PEG | PSNet
      psnet.ahrq.gov/web-mm/wrong-turn-through-colon-misplaced-peg
      May 01, 2017 - July 5, 2023 Prescribing errors in children: why they happen and how to prevent them.

2589. Labor and Delivery Unit Safety: Shoulder Dystocia | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/strategies/labor-delivery-unit/tool-shoulder-dystocia.html
      July 01, 2023 - Being aware of what is going on and what is likely to happen next.

2590. Rapid Response for Perinatal Safety: Facilitator Guide | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/strategies/rapid-response/rapid-response-fac-guide.html
      July 01, 2023 - plan is through briefings and team management, being aware of what is going on and what is likely to happen

2591. Pressure Ulcer Prevention Toolkit (doc file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/pressure_ulcer_prevention/module2/putoolkit_module2_tools.docx
      February 16, 2011 - describe key processes in your organization where pressure ulcer prevention activities could or should happen

2592. Unintentional Ketamine Overdose in the Operating Room – Mixing Up the Ampules | PSNet
      psnet.ahrq.gov/web-mm/unintentional-ketamine-overdose-operating-room-mixing-ampules
      March 25, 2020 - Similar adverse drug events related to different drug concentrations in same-size ampules also happen

2593. Around the Block | PSNet
      psnet.ahrq.gov/web-mm/around-block
      March 04, 2020 - If he did not, how could this happen?

2594. Module 2: Communication and Optimal Resolution (CANDOR) Toolkit Module 2: Obtaining Organizational Buy-in and Support
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/candor/module2/module2-obtaining-organizational-buy-in-support.pptx
      August 14, 2015 - This model describes what must happen to achieve system-wide change; it also reinforces the vital role

2595. Pocket Syringe Swap | PSNet
      psnet.ahrq.gov/web-mm/pocket-syringe-swap
      July 01, 2006 - They happen to almost every anesthesiologist sooner or later.

2596. Spotlight (pdf file)
      psnet.ahrq.gov/sites/default/files/2022-10/spotlight_case_missed_pneumothorax_10.09.2022_-_final.pdf
      January 01, 2022 - post- procedural pneumothorax with CXR, interpretation and communication of the CXR results did not happen

2597. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/33683/psn-pdf
      April 01, 2009 - That is likely to happen through a combination of other policy tools, such as pay-for-performance and

2598. The Wrong Channel | PSNet
      psnet.ahrq.gov/web-mm/wrong-channel
      February 01, 2003 - As we read about them (luckily, they never happen to us , of course), we are prompted to ask: Which

2599. Creating an Environment of Consensus –The challenges of implementing a governance structure to run an HIE (pdf file)
      digital.ahrq.gov/sites/default/files/docs/page/2006Estrin_Trk4_051311comp.pdf
      March 08, 2006 - No hidden agendas  Must provide value to those who participate  This (HIE/RHIO) will be happen.

2600. The Missing Suction Tip | PSNet
      psnet.ahrq.gov/web-mm/missing-suction-tip
      January 01, 2006 - Surgical tools left in five patients: UW surgeons take precautions to ensure it doesn’t happen again.