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301. Presentation: Program Overview
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/modules/onboarding/onboarding_overview_impmodel.pptx
     December 01, 2017 - This ensures we address the local values, attitudes, and beliefs that drive our actions. … Just finding the time to meet can be difficult. … Notice that “right” is in quotation marks, because a just, or “right” culture sends the signal that safety … Alternatively, in cultures where the “right” thing to do is to get people in and out of beds as fast … Identifying organizational cultures that promote patient safety.

302. When a surgeon should just say 'I'm sorry'. | PSNet
     psnet.ahrq.gov/issue/when-surgeon-should-just-say-im-sorry
     February 05, 2014 - Newspaper/Magazine Article When a surgeon should just say 'I'm sorry'. … Citation Text: When a surgeon should just say 'I'm sorry'. Cohen E. CNN. March 24, 2016. … URL Cite Citation Citation Text: When a surgeon should just … November 25, 2009 Hospital Survey on Patient Safety Culture: 2016 User Comparative Database

303. Background and Information for Translators of the AHRQ Hospital Survey on Pateint Safety Culture Version 2.0 (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/sops/quality-patient-safety/patientsafetyculture/hospital/sops-hsops-2-translation-guidelines.pdf
     August 01, 2023 - What is “patient safety culture”? … Patient safety culture is the extent to which an organization’s culture supports and promotes patient … Patient safety culture refers to the beliefs, values, and norms shared by healthcare practitioners and … term “unit” may be replaced by an equivalent term, such as “department,” if it suits the hospital (just … In addition, we have provided the response options for each composite measure in parentheses just below

304. Improve Safety Culture | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/quality/tools/cauti-ltc/improve.html
     March 01, 2017 - Improve Safety Culture Long-Term-Care Safety Toolkit Modules Comprises six modules (available … They support learning and implementation efforts to improve safety culture and practices in long term … AHRQ Nursing Home Survey on Patient Safety Culture A survey available for nursing homes that helps … facilities assess staff perceptions of resident safety culture and track changes over time. … designed to assist you in developing skills and strategies to improve all aspects of resident safety, not just

305. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/47228/psn-pdf
     August 09, 2018 - provide a list of practical tactics to shift health care organizations toward a more respectful and just … culture. … A PSNet perspective examined how to accelerate organizational culture change in health care. … and-part-2 https://psnet.ahrq.gov/primer/patient-engagement-and-safety https://psnet.ahrq.gov/issue/just-culture-guide … https://psnet.ahrq.gov/perspective/our-maturing-understanding-safety-culture-how-change-it-and-how-it-changes-safety

306. Appendix B. Search Terms | Agency for Healthcare Research and Quality
     www.ahrq.gov/patient-safety/reports/engage/appb.html
     March 01, 2017 - Patient satisfaction Customer service Patient Safety Patient safety Safety Safety culture … Safety climate Medical error Disclosure Adverse events Just culture Error reporting … Reporting culture Communication Error Harm Diagnostic error Defensive medicine

307. Errors in medicine: punishment versus learning medical adverse events revisited - expanding the frame. | PSNet
     psnet.ahrq.gov/issue/errors-medicine-punishment-versus-learning-medical-adverse-events-revisited-expanding-frame
     August 24, 2022 - This commentary calls for moving from the reactive "bad apple" paradigm to a proactive just culture … March 13, 2024 Requirements for implementing a 'just culture' within healthcare organisations … April 26, 2023 Effect of patient safety education interventions on patient safety culture

308. Engaging-Nurse-Physician-Patient-Transcript (doc file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/engaging-nurse-physician-patient-transcript.docx
     June 02, 2025 - Second is the physician culture can also be a barrier. … Secondly to reframe values and beliefs, third was to segment the engagement plan. … The second element is about reframing values and beliefs. … Of course this requires a change in beliefs and attitudes. Next slide. … Have a belief in what you're doing.

309. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/865491/psn-pdf
     April 03, 2024 - commentary shares strategies for organizations to facilitate recovery for these individuals, building on a just … culture including counseling services and peer support. … caring-our-own-deploying-systemwide-second-victim-rapid-response-team https://psnet.ahrq.gov/issue/system-planning-modern-day-just-culture-mitigate-worker-distress-and-second-victim-response

310. In Conversation with Jessica Behrhorst about The Evolution of Root Cause Analysis | PSNet
     psnet.ahrq.gov/perspective/conversation-jessica-behrhorst-about-evolution-root-cause-analysis
     February 26, 2025 - It is not just an event that happens and goes on a shelf. … culture, that culture of being able to speak up, that non-punitive culture where we are focused on improvement … How are we looking at human error versus reckless behavior (i.e., just culture)? … It's the same thing if we do not have just culture. … culture.  

311. The Evolution of Root Cause Analysis | PSNet
     psnet.ahrq.gov/perspective/evolution-root-cause-analysis
     February 26, 2025 - It is not just an event that happens and goes on a shelf. … culture, that culture of being able to speak up, that non-punitive culture where we are focused on improvement … How are we looking at human error versus reckless behavior (i.e., just culture)? … It's the same thing if we do not have just culture. … culture.  

312. 170-Cusp-Science-Safety-Notes (doc file)
     www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa/170-cusp-science-safety-notes.docx
     October 01, 2024 - Slide 12 So… What Is a Safety Culture? SAY: So, what is a safety culture? … It refers to the values, beliefs, and norms shared by healthcare practitioners and other personnel throughout … Patient safety culture can be measured by determining the values, beliefs, norms, and behaviors related … These are just some of the system factors at play. … A team of just physicians or just nurses won’t lead to the change efforts you’ll need.

313. Just in Time Training: Chlorhexidine Cloth Bathing or Showering Plus Mupirocin (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/hai/abate/training/jit-chg-cloth-mupirocin.pdf
     March 01, 2022 - Just in Time Training: Chlorhexidine Cloth Bathing or Showering Plus Mupirocin AHRQ Pub. … No. 20(22)-0036 March 2022 Decolonization of Non-ICU Patients With Devices Section 11-1 – Just … methicillin-resistant Staphylococcus aureus (MRSA) carriers by history, screening test, or clinical culture

314. Module 1: Overview - Facilitator's Notes | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/cauti-tools/facil-guide/preventing-cauti-icu-setting-module1-speaker-notes.html
     February 01, 2023 - We know that just because a patient is in the ICU, the patient may not require a urinary catheter. … Challenges Say: In some instances, resistance to changing catheter use practices comes from the belief … Behavior-based beliefs are a challenge. … Behavioral or Cultural Factors Say: Many ICUs obtain cultures from multiple sites when a patient … the temperature increase should warrant a critical evaluation of the patient rather than an automatic culture

315. Previous SOPS Webcasts | Agency for Healthcare Research and Quality
     www.ahrq.gov/sops/webcasts/previous.html
     June 01, 2023 - (February 19, 2020) Event Reporting and Learning System Leads to Improvements in Patient Safety Culture … (July 25, 2018) New AHRQ SOPS Value and Efficiency Supplemental Items (January 9, 2018) Using Just … Culture to Improve Hospital Survey on Patient Safety Culture Results (November 9, 2016) Introducing … the AHRQ Ambulatory Surgery Center Survey on Patient Safety Culture  (July 15, 2015) Success Stories … Safety Culture (April 29, 2011)

316. Health IT Patient Safety Supplemental Items for the SOPS Hospital Survey | Agency for Healthcare Research and Quality
     www.ahrq.gov/sops/surveys/hospital/supplemental-items/health-it.html
     September 01, 2025 - Safety Supplemental Items for the SOPS Hospital Survey The AHRQ Surveys on Patient Safety Culture … with the core  SOPS Hospital Survey to help hospitals assess the extent to which their organization's culture … The 15 supplemental items may be added to the end of the Hospital Survey, just before the Background … Pilot study results are available for just over 9,000 hospital respondents who completed the supplemental

317. Improving departmental psychological safety through a medical school-wide initiative | PSNet
     psnet.ahrq.gov/issue/improving-departmental-psychological-safety-through-medical-school-wide-initiative
     July 19, 2023 - March 20, 2024 Responding to unprofessional behavior by trainees - a "just culture" … June 5, 2019 The association between organizational culture and the ability to benefit … from "just culture" training. … Medicine Psychological and Social Complications Education and Training Students Just … Culture

318. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/852795/psn-pdf
     August 23, 2023 - Perceptions of radiation safety culture in medical imaging by role. … https://psnet.ahrq.gov/issue/perceptions-radiation-safety-culture-medical-imaging-role Fostering a culture … , which could hinder efforts to establish a just culture and a positive organizational radiation safety … culture. … /primer/culture-safety https://psnet.ahrq.gov/perspective/safety-radiology

319. Nurses: Guilty verdict for dosing mistake could cost lives. | PSNet
     psnet.ahrq.gov/issue/nurses-guilty-verdict-dosing-mistake-could-cost-lives
     April 27, 2022 - A just culture centers on moving from blaming individuals for medical errors towards a systems-based … September 28, 2022 Surveys on Patient Safety Culture (SOPS) Medical Office Survey: 2022 … Another round of the blame game: a paralyzing criminal indictment that recklessly "overrides" just … culture.

320. An Overview of the CANDOR Process
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/candor/module4/module4-event-reporting-investigation-analysis.pptx
     September 10, 2015 - A Just Culture supports disclosure and learning from errors and encourages viewing every event as an … This element supports the creation of just culture. … Improved culture of safety as a result of open, fair, and just management of individual and system issues … More information on Just Culture can be found in the Apply CUSP module of the AHRQ CUSP Toolkit. 12 … to a systems approach to Event Investigation and Analysis supports a Just Culture.