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psnet.ahrq.gov/web-mm/mark-my-limb
February 10, 2015 - world's 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.
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psnet.ahrq.gov/node/73302/psn-pdf
May 26, 2021 - How do we shift the thinking to the idea that these are harms that
may happen to the patient, be it … for bringing something forward that only makes the
organization better, but unfortunately that does happen … Why did this error happen?
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psnet.ahrq.gov/perspective/conversation-david-blumenthal-md-mpp-0
March 27, 2024 - I foresee that that's what's going to happen in the world of data. … folks who put in the original wells or created the infrastructure, who at some level don't want that to happen … the fabric of life, instead of fighting them people would turn to improving them—and that that would happen
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psnet.ahrq.gov/issue/patient-safety-10
May 01, 2023 - May 1, 2023
Program encourages reporting accidents waiting to happen: the Good Catch
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www.ahrq.gov/ncepcr/tools/self-mgmt/what-script.html
February 01, 2016 - What is Self-Management Support? (Video Transcript)
Self-Management Support
For me self management support is helping the patient to play an active role in their healthcare and to become a partner with the nurse and physician team instead of the recipient of care.
Hello Ms. Mason. How are you doing today? W…
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www.ahrq.gov/sites/default/files/wysiwyg/cahps/news-and-events/podcasts/Teamwork_in_QI_2012_02_01_Transcript.pdf
January 01, 2012 - Marjie Harbrecht
So really as I was saying before, this has to happen at every level. … So it has to happen in the practice level where
the team within the practices are really working well … It also has to happen with patients and their families. … healthy and prevent a lot of the things that we see now that really are avoidable and
don’t need to happen
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www.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/teamwork/pf-engagement-fac-guide.html
July 01, 2023 - Medical providers are committed to caring for their patients; however, adverse events can happen.
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www.ahrq.gov/patient-safety/settings/long-term-care/resource/facilities/ltc/mod1sess2.html
October 01, 2014 - Changes like this that happen suddenly might be related to their medication, or they may signal a stroke … But once you're familiar with daily patterns, you'll be aware of the things that happen often and those … Sometimes systems create "an accident waiting to happen."
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psnet.ahrq.gov/node/47291/psn-pdf
October 31, 2018 - Nearly 75% happen during
psychiatric treatment, and the most common means of death is hanging.
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psnet.ahrq.gov/node/47092/psn-pdf
October 13, 2018 - still-hard-share-psos-making-progress-still-face-tech-hurdles
https://psnet.ahrq.gov/issue/could-it-happen-here-learning-other-organizations-safety-errors
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psnet.ahrq.gov/node/33682/psn-pdf
April 01, 2009 - from routine
process breakdowns because they represent unique sequences of errors that will never happen … into improvement, but when public stakeholders say that adverse events keep happening that should
not happen … We have seen this
happen with CPOE implementation and other kinds of IT implementation. … If you do not get the process
working right before you automate it, bad things can happen to patients
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www.ahrq.gov/patient-safety/settings/long-term-care/resource/facilities/ltc/mod2sess2.html
October 01, 2014 - Recommendation:
What should happen next?
What do you need?
Timeframe? … Then, in an SBAR recommendation, say what you think might need to happen next.
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psnet.ahrq.gov/node/33783/psn-pdf
April 01, 2015 - create a safe environment in an operating
room, and that turns out to be difficult and doesn't just happen … Why can't you just make
it happen? … They've learned over the last 10 years
how to get this to happen. … Even though we haven't found the magic bullet to make it happen or pulled the right lever, I'm
hopeful … Finally, I think the culture change we seek will
happen faster than we expect.
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www.ahrq.gov/hai/cusp/toolkit/content-calls/how-to-spread.html
April 01, 2013 - And I’ll say, “Yes, I do,” because what is going to happen to you over time, what you can anticipate … notion here is primarily that you have to realize if you’re going to spread it, it may occasionally happen … Okay, so it could happen either way, but you need the support of management, generally, in order to be … So you want to make sure that it doesn’t happen to you by doing a little planning up front. … have many people on the line who are in the same position where they are pretty much making this thing happen
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www.ahrq.gov/sites/default/files/wysiwyg/cahps/surveys-guidance/item-sets/CG/administering_cg_narrative_items.pdf
June 01, 2021 - About the CAHPS Patient Narratives Elicitation Protocol
June 2021
Administering the CAHPS® Clinician &
Group Narrative Item Set
Introduction ......................................................................................................... 1
Placing the Narrative Items in the Survey ......................…
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psnet.ahrq.gov/perspective/removing-insult-injury-disclosing-adverse-events
February 01, 2006 - He "feels" himself and his world intensely, so that when an error comes along, two things happen: first … As I started learning about errors, how they happen, and how complex and multi-factorial they often are … and, number two, "What's going to happen to me as a result of this?"
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psnet.ahrq.gov/node/47777/psn-pdf
January 01, 2021 - care professionals can optimize the patient experience even when complications and safety events
happen
-
psnet.ahrq.gov/node/33628/psn-pdf
February 01, 2006 - He "feels" himself and his world
intensely, so that when an error comes along, two things happen: first … As I started learning about errors, how they happen, and how complex and
multi-factorial they often … and, number two, "What's going to happen to me
as a result of this?"
-
psnet.ahrq.gov/node/39193/psn-pdf
April 21, 2011 - psnet.ahrq.gov/issue/disclosing-harmful-mammography-errors-patients
Disclosing errors to patients does not happen
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/cusptoolkit/modules/patfamilyengagement/CUSP_Patient_Family_Engagement_Facilitator_Notes.docx
June 02, 2025 - Medical providers are committed to caring for their patients; however, adverse events can happen.