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341. 26,000 Close Call Reports: Lessons from the University of Texas Close Call Reporting System (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Simmons_66.pdf
     April 03, 2008 - The Good Catch Program was established in the organizational culture by relating the reporting process … • Promoting a fair and just culture for error reporting. … raised questions about why units with more submitted reports were being recognized, while units that just … Developing a culture of patient safety at the VA. Ambul Outreach, 2000: 25- 29. 21. Coyle GA. … Patient safety and the “just culture”: A primer for health care executives.

342. AHRQ Statistical Brief Explores Healthcare Spending for Children With Autism | Agency for Healthcare Research and Quality
     www.ahrq.gov/news/newsletters/e-newsletter/971.html
     August 01, 2025 - Celebrating National ASC Month: Unlock SOPS® Resources for Enhanced Patient Safety Culture . … AHRQ Statistical Brief Explores Healthcare Spending for Children With Autism Just over 1 percent of children … Celebrating National ASC Month: Unlock SOPS® Resources for Enhanced Patient Safety Culture In celebration … observance, AHRQ encourages ASCs to explore valuable free tools offered by the Surveys on Patient Safety Culture … without insurance considered their access to medical care to be fair or poor in 2021, compared with just

343. Conclusions | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/cusp/cauti-interim/cauti-interim5.html
     July 01, 2013 - Executive Summary Introduction and Objectives Methods Results Outcome and Process Measures Culture … national project team is committed to the overall project goals of reducing CAUTI and enhancing the safety culture … Offer a foundational understanding of Just Culture and examples of applications. … techniques to address challenging issues such as coaching from a distance, assessing organizational culture … Furthermore, data collection related to the assessment of safety culture is ongoing.

344. Surveys on Patient Safety Culture (SOPS) Ambulatory Surgery Center Survey: 2023 User Database Report Part I (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/asc/2023-ASC-Database-Report-I.pdf
     January 01, 2023 - refers to the beliefs, values, and norms shared by staff throughout their organization that influence … Patient safety culture is the extent to which these beliefs, values, and norms support and promote patient … Just before the start of procedures, all t eam members stopped to discuss the overa ll plan of what … (Item G1) 94% Just before the start of procedures, the doctor encouraged all t eam members to speak … (Item G1) 94% 7.31% 60% 86% 91% 96% 100% 100% 100% Just before the start of procedures, the doctor

345. Surveys on Patient Safety Culture (SOPS) Ambulatory Surgery Center Survey: 2023 User Database Report Part I (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/asc/2023-ASC-Database-Report-I-rev.pdf
     January 01, 2023 - refers to the beliefs, values, and norms shared by staff throughout their organization that influence … Patient safety culture is the extent to which these beliefs, values, and norms support and promote patient … Just before the start of procedures, all t eam members stopped to discuss the overa ll plan of what … (Item G1) 94% Just before the start of procedures, the doctor encouraged all t eam members to speak … (Item G1) 94% 7.31% 60% 86% 91% 96% 100% 100% 100% Just before the start of procedures, the doctor

346. The Future of Pediatric Diagnostic Safety Research | Agency for Healthcare Research and Quality
     www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-pediatric-safety-5.html
     August 01, 2023 - the Diagnostic Process and Missed Diagnostic Opportunities in Pediatric Care Settings We have only just … of diagnostic uncertainty. 134 Teamwork and communication. 135 The clinical work environment and culture … Building a diagnostic safety culture that supports event reporting and learning. … Teamwork, team cognition, safety culture, communication, and patient/family-centeredness are some of … technologies, AI’s thoughtful implementation into complex clinical workflows must be carefully considered just

347. Tool 4 (continued) | Agency for Healthcare Research and Quality
     www.ahrq.gov/es/patient-safety/settings/hospital/red/toolkit/redtool4ref.html
     March 01, 2025 - Culture, illness, and care. Ann Intern Med 1978;88:251-8. Johnstone MJ, Kanitsaki O. … Culture, language, and patient safety: making the link. Int J Qual Health Care 2006;18(5):383-8. … Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research. … Health literacy, health inequality, and a just health care system. Am J Bioeth 2007 Nov;7(11):5-10. … Language, culture, and medical tragedy: the case of Willie Ramirez.

348. Tool 4 (continued) | Agency for Healthcare Research and Quality
     www.ahrq.gov/patient-safety/settings/hospital/red/toolkit/redtool4ref.html
     March 01, 2025 - Culture, illness, and care. Ann Intern Med 1978;88:251-8. Johnstone MJ, Kanitsaki O. … Culture, language, and patient safety: making the link. Int J Qual Health Care 2006;18(5):383-8. … Culture, illness, and care: clinical lessons from anthropologic and cross-cultural research. … Health literacy, health inequality, and a just health care system. Am J Bioeth 2007 Nov;7(11):5-10. … Language, culture, and medical tragedy: the case of Willie Ramirez.

349. AHRQ Ambulatory Surgery Center Survey on Patient Safety Culture: User’s Guide (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patientsafetyculture/asc/userguide/ascguide.pdf
     April 01, 2015 - values, beliefs, and norms about what is important and what attitudes and behaviors are expected and … If you choose to do so, add these items just before the Background Questions section. … Just before the start of procedures, all team members stopped to discuss the overall plan of what was … Just before the start of procedures, the doctor encouraged all team members to speak up at any time if … Just before the start of procedures, the doctor encouraged all team members to speak up at any time

350. AHRQ Ambulatory Surgery Center Survey on Patient Safety Culture: User’s Guide (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patientsafetyculture/asc/resources/ascguide.pdf
     April 01, 2015 - values, beliefs, and norms about what is important and what attitudes and behaviors are expected and … If you choose to do so, add these items just before the Background Questions section. … Just before the start of procedures, all team members stopped to discuss the overall plan of what was … Just before the start of procedures, the doctor encouraged all team members to speak up at any time if … Just before the start of procedures, the doctor encouraged all team members to speak up at any time

351. Breaking Down Barriers to Aseptic Catheter Insertion (May 12, 2015) | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/cauti-tools/archived-webinars/breaking-down-barriers-transcript.html
     December 01, 2017 - It's important, I think, to develop a culture where evidence-based practice is recognized and rewarded … This is a big emphasis in the CUSP program, is this whole evidence of developing a culture. … Other strategies that can help improve execution is a non-punitive culture, as I mentioned before. … Visible and supportive leadership, which is also part of a culture. … Just go ahead and check the box. Just want to see what everyone's results are. Okay.

352. Breaking-Down-Barriers-Transcript (doc file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/breaking-down-barriers-transcript.docx
     May 12, 2015 - It's important, I think, to develop a culture where evidence-based practice is recognized and rewarded … This is a big emphasis in the CUSP program, is this whole evidence of developing a culture. … Other strategies that can help improve execution is a non-punitive culture, as I mentioned before. … Visible and supportive leadership, which is also part of a culture. … Just go ahead and check the box. Just want to see what everyone's results are. Okay.

353. 5 Tk2 P2T3-Antibiogram Specifications Phase 2 (doc file)
     www.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK2_P2T3-Antibiogram_specifications_Phase_2.doc
     June 02, 2025 - The antibiogram should only include culture results from specimens that were taken to diagnose clinical … Some patients receive multiple microbiological cultures during their stay in a nursing home. … Antimicrobial sensitivity results from clinical culture specimens are frequently reported in three categories … S.aureus specimens should be reported as two populations: (1) all S. aureus isolates and (2) just MRSA … FORMCHECKBOX FORMCHECKBOX Include only diagnostic isolates (not surveillance cultures).

354. Surveys on Patient Safety Culture (SOPS) Ambulatory Surgery Center Survey: 2021 User Database Report Part I (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/asc/Part-I-SOPS-ASC-DatabaseReport.pdf
     December 01, 2021 - Part I SURVEYS ON PATIENT SAFETY CULTURE™ Surveys on Patient Safety Culture™ Ambulatory Surgery … refers to the beliefs, values, and norms shared by staff throughout the organization that influence … Patient safety culture is the extent to which these beliefs, values, and norms support and promote patient … (Item G1) 95% 6.82% 60% 86% 93% 99% 100% 100% 100% Just before the start of procedures, the doctor … ASCs with 1 to 2 operating/procedure rooms had the highest average percent positive for the item “Just

355. 5 Tk2 T3-Concise Antibiogram Toolkit Using Whonet To Create Your Antibiogram (doc file)
     www.ahrq.gov/sites/default/files/wysiwyg/nhguide/5_TK2_T3-Concise_Antibiogram_Toolkit_Using_WHONET_to_Create_Your_Antibiogram.doc
     May 01, 2014 - This software will analyze the culture results of your nursing home facility and supply you with the … It should be noted that these are just suggestions, and you may end up modifying the field definitions … Under “Organisms,” select all the organisms that have been found in cultures at your facility. 4. … Under “Data files,” select the Text file that you created from your culture data. … Antibiogram Template”) seem to fit with the frequency at which you’ve seen these organisms in positive cultures

356. Paul Tedrick (doc file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/building-team-transcript.doc
     April 08, 2014 - First, to improve the culture of safety on your unit, using the model of the comprehensive unit-based … Again, improving your unit culture safety and reducing the CAUTI's through the technical work of the … In terms of the culture work, they will be responsible to implement the CUSP model by ensuring that the … Have you shared the two project goals; the goal of reducing CAUTI’s and improving the safety culture … And just not be in the mindset that just because they’re in the ICU that the catheter is mandatory.

357. Building a Team and Process to Reduce CAUTI Risk (April 8, 2015) | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/cauti-tools/archived-webinars/building-teamwork-transcript.html
     December 01, 2017 - First, to improve the culture of safety on your unit, using the model of the comprehensive unit-based … Again, improving your unit culture safety and reducing the CAUTI's through the technical work of the … In terms of the culture work, they will be responsible to implement the CUSP model by ensuring that the … Have you shared the two project goals; the goal of reducing CAUTI's and improving the safety culture … And just not be in the mindset that just because they're in the ICU that the catheter is mandatory.

358. Exhibit 5.2. Heights Hospital | Agency for Healthcare Research and Quality
     www.ahrq.gov/practiceimprovement/systemdesign/leancasestudies/lean-exhibit5-2.html
     November 01, 2014 - executive director, appointed in 2008, is extremely committed to Lean (called "Project Advance" or just … "Advance" by the corporation [our pseudonym for the actual name]) and to an open and participatory culture … Heights Hospital uses "rapid improvement events" (RIEs) to implement Lean projects and provides just-in-time

359. Improving Hospital Handoffs Using AHRQ’s Surveys on Patient Safety Culture® Hospital Survey - Hansford and Murray (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/sops/events/webinar/03-sops-riverside-handoffs-webcast-hansford.pdf
     January 01, 2023 - Improving Hospital Handoffs Using AHRQ’s Surveys on Patient Safety Culture® Hospital Survey - Hansford … and Murray Assessing Patient Safety Culture to Improve Hospital Handoffs Ashley Hansford, BS, CPPS … of continuous learning, improvement and operational excellence, fostering a fair and just environment … Ensure every team member feels empowered and accountable for safety, as evidenced by the Safety Culture … Culture: LeapFrog & Patient Safety Riverside- SOPS Survey Administration • Annually (Fall) • Open

360. Candor-Impguide (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/candor/candor-impguide.pdf
     April 01, 2016 - The CANDOR process1 improves patient safety through an empathetic, fair, and just approach to medical … approach that health care institutions and practitioners can use to respond in a timely, thorough, and just … approach that health care institutions and practitioners can use to respond in a timely, thorough, and just … Culture principles support CANDOR process implementation. … Phase II is the implementation of the CANDOR process, which operationalizes a timely, thorough and just