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Showing results for "leader".

  1. 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 - In Conversation with Jessica Behrhorst about The Evolution of Root Cause Analysis Jessica Behrhorst, MPH, CPPS, CPHRM, CPHQ; Bryan Gale, MA; Cindy Manaoat Van, MHSA, CPPS | February 26, 2025  Also Read the Essay View more articles from the same authors. Citation T…

  2. In Conversation with Lucy Savitz about Learning Health Systems for Patient Safety | PSNet

    psnet.ahrq.gov/perspective/conversation-lucy-savitz-about-learning-health-systems-patient-safety
    February 26, 2025 - In Conversation with Lucy Savitz about Learning Health Systems for Patient Safety Lucy A. Savitz, MBA, PhD; Zoe Sousane, BS; Sarah E. Mossburg, RN, PhD | February 26, 2025  Also Read the Essay View more articles from the same authors. Citation Text: Savitz LA, S…

  3. Learning Health Systems for Patient Safety | PSNet

    psnet.ahrq.gov/perspective/learning-health-systems-patient-safety
    February 26, 2025 - Learning Health Systems for Patient Safety Lucy A. Savitz, MBA, PhD; Zoe Sousane, BS; Sarah E. Mossburg, RN, PhD | February 26, 2025  Also Read the Conversation View more articles from the same authors. Citation Text: Savitz LA, Sousane Z, Mossburg SE. Learning …

  4. Final Progress Report: Generalizability and Spread of an Evidenced-based Fall Prevention Toolkit: Fall TIPS (pdf file)

    www.ahrq.gov/sites/default/files/2024-04/dykes-report.pdf
    January 01, 2024 - Nurse Leader. 2019 Aug; 17(4):365-370.

  5. The Evolution of Root Cause Analysis | PSNet

    psnet.ahrq.gov/perspective/evolution-root-cause-analysis
    February 26, 2025 - The Evolution of Root Cause Analysis Jessica Behrhorst, MPH, CPPS, CPHRM, CPHQ; Bryan Gale, MA; Cindy Manaoat Van, MHSA, CPPS | February 26, 2025  Also Read the Conversation View more articles from the same authors. Citation Text: Behrhorst J, Gale B, Van CM. Th…

  6. Improving Healthcare Through AHRQ's Digital Healthcare Research Program: 2023 Year in Review (pdf file)

    digital.ahrq.gov/sites/default/files/ahrq-dhr-2023-year-in-review.pdf
    January 01, 2023 - - - AHRQ is a leader in patient-centered clinical decision support research. … year, the CDSiC has created numerous resources to further the field of PC CDS, anchoring AHRQ as a leader … ’s Digital Healthcare Research Program: 2023 Year in Review 30 At HealthPartners, which has been a leader

  7. Methods Research Report: Improving Health Systems' Access to High-Quality Evidence: AHRQ EPC 2018 Pilot Projects Summary (pdf file)

    effectivehealthcare.ahrq.gov/sites/default/files/pdf/methods-report-improving-health-systems-access.pdf
    August 01, 2019 - EPCs will do this by engaging with a health system leader to develop a dissemination product based on … EPCs shall: o Identify a health system leader by name, organization, and role o Develop pilot product … will accelerate uptake and implementation of findings from EPC report with input from health system leader

  8. Final Report -- State and Regional Demonstration in Health Information Technology: Rhode Island (pdf file)

    digital.ahrq.gov/sites/default/files/docs/citation/state-regional-demonstration-hit-ri-final-report.pdf
    December 01, 2015 - enhance buy-in and produce well- informed technical solutions, however, heavy handed partners and opinion leader

  9. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33715/psn-pdf
    July 01, 2011 - Becoming a Patient Safety Organization July 1, 2011 Jaffe R. Becoming a Patient Safety Organization. PSNet [internet]. 2011. https://psnet.ahrq.gov/perspective/becoming-patient-safety-organization Perspective While I was the first employee of the California Hospital Patient Safety Organization (CHPSO), its story …

  10. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33827/psn-pdf
    February 01, 2017 - New Insights About Team Training From a Decade of TeamSTEPPS February 1, 2017 Baker DP, King HB, Battles J. New Insights About Team Training From a Decade of TeamSTEPPS. PSNet [internet]. 2017. https://psnet.ahrq.gov/perspective/new-insights-about-team-training-decade-teamstepps Perspective Ten years ago, the Ag…

  11. lessons learned, successes, and barriers for the ‘Real-Time’ and QIO ‘ON-Time’ projects (pdf file)

    digital.ahrq.gov/sites/default/files/docs/resource/Real_Time_and_On_Time_Lessons_Learned_9_6_06.pdf
    June 16, 2021 - lessons learned, successes, and barriers for the ‘Real-Time’ and QIO ‘ON-Time’ projects 1 LESSONS LEARNED, SUCCESSES, AND BARRIERS FOR THE ‘REAL-TIME’ AND QIO ‘ON-TIME’ PROJECTS LESSONS LEARNED 1. Partnerships are effective to initiate and support change. Partnerships within facilities (multi-disciplina…

  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49503/psn-pdf
    February 01, 2006 - Workaround Error February 1, 2006 Pape T. Workaround Error. PSNet [internet]. 2006. https://psnet.ahrq.gov/web-mm/workaround-error The Case A retired 81-year-old physician with metastatic colon cancer was admitted to an acute care hospital with pneumonia and congestive heart failure (CHF). After his acute hospita…

  13. Executive Summary: Comparative Effectiveness Review No. 256_Effectiveness of Telehealth for Women's Preventive Services (pdf file)

    effectivehealthcare.ahrq.gov/sites/default/files/related_files/cer-256-telehealth-women-preventive-services-executive-summary.pdf
    June 01, 2022 - Executive Summary: Comparative Effectiveness Review No. 256_Effectiveness of Telehealth for Women's Preventive Services Comparative Effectiveness Review Number 256 Effectiveness of Telehealth for Women’s Preventive Services Executive Summary Main Points • Based on 16 studies, outcomes of telehealth intervent…

  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/866621/psn-pdf
    August 28, 2024 - Application of Safety-II Principles August 28, 2024 Venkatesan C, Helak K, Sousane Z, et al. Application of Safety-II Principles. PSNet [internet]. 2024. https://psnet.ahrq.gov/perspective/application-safety-ii-principles Traditional approaches to patient safety have often been reactive rather than proactive, seeki…

  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33824/psn-pdf
    January 01, 2016 - Patient Safety and Opioid Medications January 1, 2016 Sarkar U, Shojania KG. Patient Safety and Opioid Medications. PSNet [internet]. 2016. https://psnet.ahrq.gov/perspective/patient-safety-and-opioid-medications Annual Perspective 2016 Opioid medications confer significant risks of harm, including overdose death …

  16. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33848/psn-pdf
    December 01, 2017 - The Evolution of Patient Safety in Surgery December 1, 2017 Wachter R. The Evolution of Patient Safety in Surgery. PSNet [internet]. 2017. https://psnet.ahrq.gov/perspective/evolution-patient-safety-surgery Perspective In 1979, 20 years before the Institute of Medicine's To Err Is Human report (1) catalyzed the cr…

  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33679/psn-pdf
    January 01, 2009 - Disclosure of Medical Error January 1, 2009 Kachalia A. Disclosure of Medical Error. PSNet [internet]. 2009. https://psnet.ahrq.gov/perspective/disclosure-medical-error Perspective Disclosure of medical error is inextricably linked to today's patient safety efforts. Health care experts advocate that greater discl…

  18. Monitoring Progress for Sustainable Improvement (pdf file)

    www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/e1_combo_monitorprogress.pdf
    June 02, 2025 - Monitoring Progress for Sustainable Improvement Toolkit for Using the AHRQ Quality Indicators How To Improve Hospital Quality and Safety Monitoring Progress for Sustainable Impro…

  19. CMV_27_M3_CUSP_SSA_Premortem

    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/cusp/overview-cuspmvp-slides.pptx
    January 01, 2017 - CMV_27_M3_CUSP_SSA_Premortem Overview of the Comprehensive Unit-based Safety Program for Application to Mechanically Ventilated Patients AHRQ Safety Program for Mechanically Ventilated Patients AHRQ Pub. No. 16(17)-0018-27-EF January 2017 Overview of CUSP for MVP ‹#› AHRQ Safety Program for Mechanically Ventilat…

  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/49435/psn-pdf
    February 01, 2004 - X-ray Flip February 1, 2004 Shapiro MJ. X-ray Flip. PSNet [internet]. 2004. https://psnet.ahrq.gov/web-mm/x-ray-flip The Case A 19-year-old man presented to the emergency department with respiratory distress after blunt chest trauma. A digital chest radiograph was labeled backwards; a "left" marker was mistakenly…
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