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Total Results: 372 records

Showing results for "happened".

21. Understand the Science of Safety for Perinatal Safety (pdf file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/understand/understand-facilitator-guide.pdf
    May 01, 2017 - When learning from defects, L&D unit teams identify— • What happened? • Why did it happen? … Analyzing what happened and why it happened helps the team understand the contributing factors and … • What happened? • Why did it happen? • How will you reduce the risk of recurrence?

22. Questions & Answers: The CAHPS Patient Narrative Elicitation Protocol (pdf file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/cahps/surveys-guidance/item-sets/elicitation/cahps-patient-narrative-elicitation-protocol-qa-03-01-2017.pdf
    January 01, 2017 - Please explain what happened, how it happened, and how it felt to you. PN-4. … Please explain what happened, how it happened, and how it felt to you. PN-5.

23. Understand the Science of Safety for Perinatal Safety: Facilitator Guide | Agency for Healthcare Research and Quality
    www.monahrq.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/teamwork/understand-sci-fac-guide.html
    July 01, 2023 - When learning from defects, L&D unit teams identify— What happened? Why did it happen? … Analyzing what happened and why it happened helps the team understand the contributing factors and processes … What happened? Why did it happen? How will you reduce the risk of recurrence?

24. Learn-From-Defects-Facilitator-Guide (doc file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/sensemaking/learn-from-defects-facilitator-guide.docx
    May 01, 2017 - Defects identification CUSP asks L&D unit staff to work through a defect and ask— What happened? … The recovery side is completed when the event is a near miss, that is, something that happened to stop … What happened? Step 1. Reconstruct the timeline to understand what happened. Step 2.

25. Implementing the New CAHPS Protocol for Obtaining Patient Comments About Their Care (pdf file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/cahps/news-and-events/events/webinars/implementing-new-protocol-transcript.pdf
    October 01, 2018 - Because before understanding what has actually happened to a patient we need to know what it is that … We probe, please explain what happened, how it happened and how it felt to you in order to get that complete … And again please explain what happened, how it happened and how it felt to you. … Is this something that happened once or is this something that happens to you often? … And how did what happened get brought about?

26. Job Aid: “Last 10 Patients” Chart Audit (pdf file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/ncepcr/resources/job-aid-last10-patients-audit.pdf
    May 18, 2021 - ago, care may not reflect current processes, and clinicians and staff may not be able to recall what happened

27. New Mexico IMPaCT: Catalyzing Community Health Transformation in Kansas (pdf file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/primary-care/tpc/impact-ks-success-story.pdf
    April 01, 2015 - “We were motivated by collaborations that had happened between the University of New Mexico and New … cooperative extension folks at Kansas State to develop collaborations, which is not something that had happened

28. Sensemaking and Learn from Defects for Perinatal Safety (pdf file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/sensemaking/learn-from-defects-facilitator-guide.pdf
    May 01, 2017 - Defects identification CUSP asks L&D unit staff to work through a defect and ask— • What happened … The recovery side is completed when the event is a near miss, that is, something that happened to stop … What happened? • Step 1. Reconstruct the timeline to understand what happened. • Step 2.

29. Event Investigation and Analysis Guide: Appendix D | Agency for Healthcare Research and Quality
    www.monahrq.ahrq.gov/patient-safety/settings/hospital/candor/modules/guide4/apd.html
    August 01, 2022 - What happened during the handoff? … Was there anything that happened during the handoff that may have contributed to the event?    

30. Pf-Engagement-Facilitator-Guide (doc file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/engage/pf-engagement-facilitator-guide.docx
    May 01, 2017 - Providers communicate the facts of what happened and assure the patient and family that they will receive … A hospital committed to transparency offers an apology that the incident happened. … communicated to the patient and family: An apology for any unreasonable care An explanation of what happened

31. Sensemaking and Learn From Defects for Perinatal Safety: Facilitator Guide | Agency for Healthcare Research and Quality
    www.monahrq.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/teamwork/learn-from-defects-fac-guide.html
    July 01, 2023 - Defects identification CUSP asks L&D unit staff to work through a defect and ask— What happened? … The recovery side is completed when the event is a near miss, that is, something that happened to stop … What happened? Step 1. Reconstruct the timeline to understand what happened. Step 2.

32. New Mexico IMPaCT: Catalyzing Community Health Transformation in Kansas | Agency for Healthcare Research and Quality
    www.monahrq.ahrq.gov/ncepcr/research-transform-primary-care/transform/impactgrants/impact-ks-success-story.html
    April 01, 2015 - “We were motivated by collaborations that had happened between the University of New Mexico and New Mexico … cooperative extension folks at Kansas State to develop collaborations, which is not something that had happened

33. CUSP Videos | Agency for Healthcare Research and Quality
    www.monahrq.ahrq.gov/hai/cusp/videos/index.html
    September 01, 2019 - Identifying and Ranking Defects What Happened? Why Did It Happen?

34. Engage Patients and Families for Perinatal Safety (pdf file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/engage/pf-engagement-facilitator-guide.pdf
    May 01, 2017 - Providers communicate the facts of what happened and assure the patient and family that they will receive … A hospital committed to transparency offers an apology that the incident happened. … communicated to the patient and family: • An apology for any unreasonable care • An explanation of what happened

35. Patient and Family Engagement for Perinatal Safety: Facilitator Guide | Agency for Healthcare Research and Quality
    www.monahrq.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/teamwork/pf-engagement-fac-guide.html
    July 01, 2023 - Providers communicate the facts of what happened and assure the patient and family that they will receive … A hospital committed to transparency offers an apology that the incident happened. … An explanation of what happened. A meaningful discussion of projected outcomes.

36. Sensemaking and Learn From Defects for Perinatal Safety | Agency for Healthcare Research and Quality
    www.monahrq.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/teamwork/learn-from-defects-slides.html
    July 01, 2023 - The discovery event addresses what happened. … Arrows pointing downward lead from one question to the next: Question 1: What happened?

37. Module 4: Event Reporting, Event Investigation and Analysis | Agency for Healthcare Research and Quality
    www.monahrq.ahrq.gov/patient-safety/settings/hospital/candor/modules/notes4.html
    August 01, 2022 - To strengthen system accountability, we want to learn what happened, why it happened, what normally happens

38. Module 2: Example (doc file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/ambulatory-surgery/sections/sustainability/management/visual/visual-mgmt-pdsa-form.docx
    May 01, 2017 - Module 2: Example AHRQ Safety Program for Ambulatory Surgery Management Practices for Sustainability Module 5: Visual Management Sample “Plan-Do-Study-Act”[footnoteRef:1] Form [1: “Plan-Do-Study-Act” refers to a method for testing changes in clinical practice. In the “plan” step, lay out the specifications of your…

39. Strategy 6Q: Standards for Customer Service | Agency for Healthcare Research and Quality
    www.monahrq.ahrq.gov/cahps/quality-improvement/improvement-guide/6-strategies-for-improving/customer-service/strategy6q-custservice-standards.html
    March 01, 2020 - "It's the doctor's fault and I can't believe that happened." "I'm sorry that happened.

40. Survey on Patient Safety (facility version) (doc file)
    www.monahrq.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/hospital/facilscanform.doc
    November 15, 2019 - Survey on Patient Safety (facility version) Survey on Patient Safety Instructions This survey asks for your opinions about patient safety issues, medical error, and event reporting in your facility and will take about 10 to 15 minutes to complete. If you do not wish to answer a question, or if a question does not app…