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201. Using a Tiered Approach With CUSP Principles Facilitator Guide (doc file)
     www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/tiered-approach-notes.docx
     April 01, 2022 - A “Just Culture” is a system in which staff members and the system itself are held accountable. … More information to reinforce “Just Culture” principles can be found in a short, 5-minute video from … Slide 7 A “Just Culture” environment supports improved outcomes by emphasizing both well-designed … Additional foundational elements of a “Just Culture” are accountability and justice. … Slide 8 With the key concepts of “Just Culture” and systems theory being the backbone, CUSP can be

202. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/36323/psn-pdf
     November 14, 2018 - Our long journey towards a safety-minded just culture. Part II: where we're going. … https://psnet.ahrq.gov/issue/our-long-journey-towards-safety-minded-just-culture-part-ii-where-were-going … https://psnet.ahrq.gov/issue/our-long-journey-towards-safety-minded-just-culture-part-ii-where-were-going … https://psnet.ahrq.gov/issue/our-long-journey-towards-safety-minded-just-culture-part-i-where-weve-been

203. Pharmacy Survey Webinar Transcript (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patientsafetyculture/pharmacy/pharmwebinar/psopswebinartrans.pdf
     October 29, 2013 - But first I want to just talk about what is Patient Safety Culture? … It’s the beliefs, the values and the norms that they have. … gets really hectic and things are just moving really fast; maybe that’s the time to just take 30 seconds … And we’ll just keep working on emphasizing that safety culture. … You will just submit the electronic data to us.

204. 10 Leadership mindsets for high reliability organizations. How to empower caregivers and engage patients in patient safety. | PSNet
     psnet.ahrq.gov/issue/10-leadership-mindsets-high-reliability-organizations-how-empower-caregivers-and-engage
     August 12, 2020 - December 1, 2021 Institution of just culture physician peer review in an academic medical … October 23, 2019 Our long journey towards a safety-minded just culture. … November 13, 2018 Perspective Making Just Culture a Reality … Administrators Quality and Safety Professionals Latent Errors Quality Improvement Strategies Just … Culture

205. The morbidity and mortality conference: opportunities for enhancing patient safety. | PSNet
     psnet.ahrq.gov/issue/morbidity-and-mortality-conference-opportunities-enhancing-patient-safety
     March 17, 2021 - This article presents five recommendations to improve MMC: encourage culture change; allocate ample … foster innovative thinking; take a global approach; learn from errors and near misses; and do not just … Related Resources Reframing the morbidity and mortality conference: the impact of a just … culture. … September 30, 2020 Why accountability sharing in health care organizational cultures

206. New world of patient safety. 23rd Annual Samuel Jason Mixter Lecture. | PSNet
     psnet.ahrq.gov/issue/new-world-patient-safety-23rd-annual-samuel-jason-mixter-lecture
     November 02, 2014 - Leape advocates for just culture —a balance between systems approaches and individual accountability—and … Another round of the blame game: a paralyzing criminal indictment that recklessly "overrides" just … culture. … February 27, 2019 Creating a fair and just culture: one institution's path toward organizational … Culture

207. Mindfulness: Engaging Frontline Providers in Antimicrobial Stewardship (June 10, 2014) | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/cauti-tools/archived-webinars/mindfulness-transcript.html
     December 01, 2017 - , and then when to treat and not treat those positive urine cultures. … those cultures the right way. … Have the cultures come back? … So, three quarters do not have guidelines for ordering urine cultures, a quarter do. … Changing culture is not an easy thing to do.

208. Facilitator-Notes (doc file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/implementation/long-term-modules/module3/facilitator-notes.docx
     March 01, 2017 - A Just Culture is one that allows teams to learn from mistakes in a safe environment. … SLIDE 23 SAY: The term “Just Culture” refers to a system of shared accountability in which health … A Just Culture environment helps provide a foundation for staff empowerment. … Within the Just Culture model, five key elements contribute to improved outcomes. … SLIDE 24 SAY: A system of Just Culture recognizes that people make mistakes.

209. Support and recovery strategies for second victims. | PSNet
     psnet.ahrq.gov/issue/support-and-recovery-strategies-second-victims
     January 19, 2022 - shares strategies for organizations to facilitate recovery for these individuals, building on a just … culture including counseling services and peer support. … March 27, 2024 Creating a just culture in the perioperative setting. … Topic Operating Room Medical/Surgical Nursing Anesthesia Nursing Second victims Just … Culture View More

210. Improving Patient Safety in Nursing Homes: A Resource List (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/nursing-home/nursing-home-resource-list-2.0.pdf
     April 01, 2025 - Just Culture a. … Just Culture Decision Support Tool https://www.patientsafety.va.gov/docs/Just-Culture-Decision-Support-Tool … a Just Culture toolkit that introduces the main concepts of Just Culture, ways to implement, and case … - building/ This website provides a definition of Just Culture, presentations on Just Culture, a case … Culture Toolkit Just Culture Decision Support Tool Just In Time Toolkits: Recipes for Staffing Transformation

211. AHRQ Safety Program for Perinatal Care: Learn About the Comprehensive Unit-based Safety Program
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/learn/learn-about-cusp.pptx
     May 01, 2017 - Improvement Model for Improvement Plan-Do-Study-Act Root Cause Analysis Failure Mode Effect Analysis Just … Anchor new approaches in culture. … Culture Introduction to Just Culture Principles 12 Learn About CUSP AHRQ Safety Program for Perinatal … Care 12 Understand Just Culture CLICK LINK BELOW TO PLAY VIDEO: http://www.ahrq.gov/professionals … Just Culture. Plano, TX: Outcome Engineering; 2011.

212. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/842416/psn-pdf
     January 11, 2023 - errors that receive widespread media attention frequently spur health systems to reexamine their own culture … The action plan proposed by this project includes ensuring a just culture so staff feel empowered to … psnet.ahrq.gov/issue/fatal-solutions-how-healthcare-system-used-tragedy-transform-itself-and-redefine-just-culture … safety-intravenous-drug-delivery-systems-update-current-issues-2009-consensus-development https://psnet.ahrq.gov/issue/just-culture-restoring-trust-and-accountability-your-organization-third-edition

213. SOPS Program Brief (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/sops/sops-program-brief-2024.pdf
     January 01, 2024 - Organizational culture refers to the beliefs, values, and norms shared by staff throughout an organization … Patient safety culture is the extent to which these beliefs, values, and norms support and promote … culture. …  Examine trends in patient safety culture over time. … Supplemental items can be added toward the end of the core SOPS surveys, just before the background

214. Responding to clinicians who fail to follow patient safety practices: perceptions of physicians, nurses, trainees, and patients. | PSNet
     psnet.ahrq.gov/issue/responding-clinicians-who-fail-follow-patient-safety-practices-perceptions-physicians-nurses
     February 24, 2011 - initially built on the establishment of a no-blame philosophy, but recently experts have called for a just … culture that balances systems-based thinking with personal accountability. … An AHRQ WebM&M perspective discusses the organizational implementation of a just culture. … July 3, 2014 A just culture after Mid Staffordshire. … May 29, 2014 Development of the just culture assessment tool: measuring the perceptions

215. SOPS Supplemental Items | Agency for Healthcare Research and Quality
     www.ahrq.gov/sops/surveys/supplemental-items.html
     February 01, 2025 - SOPS Supplemental Items The AHRQ Surveys on Patient Safety Culture® (SOPS®) surveys are composed … A composite measure is a grouping of two or more survey items that assess the same area of culture. … supplemental items included in your survey must be inserted at the end of the core SOPS survey items, just … Adding Custom Survey Items  You can add your own custom survey items, but they must be inserted at the … end of the core SOPS survey items, just before the background questions. 

216. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/47457/psn-pdf
     January 17, 2019 - Developing a reporting culture: learning from close calls and hazardous conditions. … It highlights bright spots: organizations that use a just culture approach to investigating errors, … Perspective reviewed the context of the no-blame movement and the recent shift toward a framework of a just … culture. … https://psnet.ahrq.gov/issue/just-culture-guide https://psnet.ahrq.gov/perspective/accountability-patient-safety

217. Resource List - AHRQ Ambulatory Surgery Center Survey (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/asc/asc-resource-list.pdf
     April 01, 2023 - Just Culture a. … provides links to ways to engage and educate a Just Culture, execute a Just Culture, and evaluate a … Just Culture. … - building/ This website provides a definition of Just Culture, presentations on Just Culture, a case … Just Culture 4.

218. Understanding SOPS Surveys: A Primer for New Users (Webcast) Transcript (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/sops/events/webinar/SOPS101_Webcast_Transcript.pdf
     June 01, 2022 - So, what is patient safety culture? … Gray, Slide 13 Patient safety culture can be defined as the beliefs, values, and norms shared by healthcare … And then, as Caren just mentioned, Version 2.0 was released recently in 2019. … So, I wanted just to point out a little bit about the Hospital Database. … So, just so you're aware of that.

219. Just a Cup of Tea – an Introduction to the SEIPS Framework. | PSNet
     psnet.ahrq.gov/issue/just-cup-tea-introduction-seips-framework
     January 31, 2018 - Audiovisual Presentation Just a Cup of Tea – an Introduction to the SEIPS Framework … Citation Text: Just a Cup of Tea – an Introduction to the SEIPS Framework. … April 15, 2020 Broken Trust: Making Patient Safety More than Just a Promise. … March 14, 2018 A Just Culture Guide. … September 29, 2021 New AHRQ Surveys on Patient Safety Culture Diagnostic Safety Supplemental

220. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/33982/psn-pdf
     December 22, 2008 - Patient safety: it's not just carefulness, it's a culture. December 22, 2008 Powell S. … Patient Safety: it's not just carefulness, it's a culture. … https://psnet.ahrq.gov/issue/patient-safety-its-not-just-carefulness-its-culture This editorial overview …  touches upon several key elements within the field, from AHRQ's Hospital Survey on Patient Safety Culture … https://psnet.ahrq.gov/issue/patient-safety-its-not-just-carefulness-its-culture