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1161. Final Progress Report: Pharmacist Technology for Nursing Home Resident Safety (pdf file)
      www.ahrq.gov/sites/default/files/2024-01/lapane-report.pdf
      January 01, 2024 - Just four long-term care pharmacy providers service nearly 70% of the nursing facility beds in the US … We estimate avoiding just one hospitalization and rehabilitation for a preventable hip fracture would … Nurses' and nursing assistants' perceptions of patient safety culture in nursing homes.

1162. Primary Care Practice Facilitation Curriculum Module 26: An Introduction to Electronic Health Records and Meaningful Use (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/ncepcr/tools/PCMH/pcpf-module-26-ehr-and-mu.pdf
      September 01, 2015 - For practices that are just beginning their American Medical journey towards going digital, providing … FtCustom Ord""" -- 6une0e,,, ra..o1--.....- Myt:1t0m Sbom:ws::f=- C' t1<>515t, v ..

1163. Person-Centered Preventive Healthcare: Engaging in Challenging Conversations about Screening (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/ncepcr/research/engaging-challenging-full.pdf
      May 01, 2024 - Both groups can have an unwavering belief that identifying any cancer is good and can identify a story … That notion that you are cutting off care at a certain age just doesn't sit well with some people. … But it just doesn’t sit well with some people.” … But I’m just a little reluctant to put a lot of faith in how far we can go with that. … And for me, I don’t care where you are on the continuum—just be on the continuum.”

1164. Communication: Severe Hypertension (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/perinatal-care-2/hypertension_3-communication-speaker-notes.pdf
      July 01, 2023 - laboratory testing; and care decisions), • Leadership (i.e., organizational planning, organizational culture … At this point, there is an opportunity for the team to use some of the tools you just learned about. … Silliness for this activity is encouraged, even if that’s not your typical unit culture.

1165. Measure 1, Section 14, Attachment 1 (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/chipra-88-measure-1-section-14-attachment-1.pdf
      January 01, 2011 - Nearly 10% stated they did not have enough information and just over 4% indicated ‘suspected ADHD’.

1166. ADHD Performance Measurement Set (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/factsheets/fullreports/chipra-89-adhd-behavior-section-14-attach-1.pdf
      January 01, 2011 - Nearly 10% stated they did not have enough information and just over 4% indicated ‘suspected ADHD’.

1167. Final Progress Report: Sociotechnical Probabilistic Risk Assessment in Home Health Care (pdf file)
      www.ahrq.gov/sites/default/files/2025-02/silver2-report.pdf
      January 01, 2025 - the work, and • extensive field work can present barriers to establishing and maintaining a shared culture … practices – Correct process design flaws Organizational reform – Management practices – Organizational culture … over 135 hospitalizations and $685,000 annually in avoidable hospital costs to Medicare Part A for just

1168. Error Producing Conditions in the Intensive Care Unit (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol3/Advances-Drews_15.pdf
      February 26, 2008 - for help when programming a device”; “You always can tell whether something is malfunctioning or just … This tendency might even be amplified if people work in an organization marked by a culture of blame

1169. AHRQ Subcommittee of the National Advisory Council on Healthcare Quality Measurement: Executive Summary (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/cpi/about/organization/nac/snac-executive-summary.pdf
      October 19, 2021 - that AHRQ lead endeavors to use quality measurement to address and eliminate disparities rather than just … In just 12 months, this work fueled a reduction in annual costs per patient in the UH ACO by 9 percent

1170. References | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/reports/engage/references.html
      May 01, 2023 - Patient safety culture in primary care: developing a theoretical framework for practical use. … Patient safety culture in primary care: developing a theoretical framework for practical use. … Is ambulatory patient safety just like hospital safety, only without the “stat”? … Using the Health Belief Model to explain patient involvement in patient safety.

1171. Appendix III (continued) | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/report/apiiie.html
      June 01, 2010 - This is just one component of the four-pronged approach to monitoring the waivers.

1172. Final Progress Report: Identifying and Reducing Errors in Perioperative Anesthesia Medication Delivery (pdf file)
      www.ahrq.gov/sites/default/files/2025-02/catchpole2-report.pdf
      January 01, 2025 - AIM 3: Understand and improve workspace design and safety culture to influences anesthesia medication … predominant cause of variability in the management of a case; an anesthesia provider may diverge in just … Not all clinicians are equally aware of just how tasks, technologies, workspace, and organization interact

1173. Final Progress Report: Addressing Patients' Multiple Concerns in Primary Care (pdf file)
      www.ahrq.gov/sites/default/files/2024-07/heritage-report.pdf
      January 01, 2024 - structure of the questions and their wording provides information about ourselves, our intent, our beliefs … significant covariates, SOME visits were about 6 seconds longer than controls (p=.89), and ANY visits were just

1174. Transitioning Newborns from NICU to Home: Family Information Packet (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/nicu_toolkit/nicupacket.pdf
      December 01, 2013 - – Usually occurs just superior to the internal stoma site on the anterior tracheal wall. … ■ Suprastomal collapse – Pressure on tracheal cartilage just superior to the stoma may cause chondritis … ■ Send swab for culture and treat with appropriate topical or systemic antibiotics. … ■ Obtain stool sample for culture. ■ Ask dietician to review feed and rate.

1175. Transitioning Newborns from NICU to Home: Family Information Packet (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/patient-safety/settings/hospitals/nicupacket.pdf
      December 01, 2013 - – Usually occurs just superior to the internal stoma site on the anterior tracheal wall. … ■ Suprastomal collapse – Pressure on tracheal cartilage just superior to the stoma may cause chondritis … ■ Send swab for culture and treat with appropriate topical or systemic antibiotics. … ■ Obtain stool sample for culture. ■ Ask dietician to review feed and rate.

1176. Final Progress Report: Engineering Highly Reliable Communication and Coordination Systems for High-Risk Patients, Referrals, and Tests (pdf file)
      www.ahrq.gov/sites/default/files/2025-03/singer-benneyan-phillips-report.pdf
      January 01, 2025 - compare and contrast methods applied and challenges encountered and addressed across projects, not just … Reducing Hospital Errors: Interventions that Build Safety Culture. … Is ambulatory patient safety just like hospital safety, only without the “stat”? … The culture of safety: Results of an organization-wide survey in 15 California hospitals.

1177. Final Progress Report: Medications at Transitions and Clinical Handoffs (MATCH) (pdf file)
      www.ahrq.gov/sites/default/files/2024-01/noskin-report.pdf
      January 01, 2024 - Just like pilot testing, there are several different strategies to roll out the medication reconciliation

1178. Section 8: The Care Management Evidence Base | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/medicaidmgmt/mm8.html
      October 01, 2014 - Noting that few studies reviewed just one intervention is important.

1179. Pressure Injury Prevention Program Implementation Guide (doc file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/pressure_ulcer_prevention/pu_training-impguide.docx
      October 01, 2017 - Readiness To Launch AHRQ’s Pressure Injury Prevention Program Question Answer Does your hospital have a culture … The team should focus on just a few key interventions. … the interventions and improved outcomes normal, integrated, and mainstream—part of your hospital’s culture … If participants have trouble putting an idea in the quadrant labeled “kill,” explain that “kill” just

1180. The AAFP Patient Safety Reporting System: Development and Legal Issues Pertinent to Medical Error Tracking and Analysis (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol3/Phillips.pdf
      January 01, 2004 - 5 intensive reporting days during which they were to report every error they witnessed rather than just … There should be a nonpunitive culture for reporting health care errors that focuses on preventing and