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201. Module 8: Organizational Learning and Sustainability | Agency for Healthcare Research and Quality
     www.ahrq.gov/patient-safety/settings/hospital/candor/modules/notes8.html
     August 01, 2022 - The Implementation Team Lead and other Team Leads help build and promote a shared vision of organizational … The CANDOR Implementation Team Lead and Team Leads play an important role in ensuring that frontline … Team leads should continue to be coached to motivate leaders and team members to support program interventions … Encourage your Team Leads to discuss actual CANDOR events to drive home important lessons.

202. Behavioral Counseling Interventions: An Evidence-based Approach - Figure 2 | United States Preventive Services Taskforce
     www.uspreventiveservicestaskforce.org/uspstf/behavioral-counseling-interventions-evidence-based-approach-figure-2
     November 01, 2013 - An arrow leads from this assessment arrow below to potential "Adverse Effects" (key question 4). … Staying on the same line, the "Intervention" arrow leads to the next box "Measures of Behavior Change … This arrow leads to a final box on the line "Ongoing or Sustained Behavior Change."

203. Misidentification of alphanumeric symbols in both handwritten and computer-generated information. | PSNet
     psnet.ahrq.gov/issue/misidentification-alphanumeric-symbols-both-handwritten-and-computer-generated-information
     May 07, 2018 - Related Resources From the Same Author(s) Failed check system for chemotherapy leads … June 10, 2018 Failed check system for chemotherapy leads to pharmacist's "no contest"

204. ISMP updates its list of drug name pairs with Tall man letters. | PSNet
     psnet.ahrq.gov/issue/ismp-updates-its-list-drug-name-pairs-tall-man-letters
     June 10, 2018 - From the Same Author(s) Electronic prescribing vulnerabilities: height and weight mix-up leads … May 7, 2018 Misprogramming PCA concentration leads to dosing errors.

205. Misidentification of alphanumeric symbols. | PSNet
     psnet.ahrq.gov/issue/misidentification-alphanumeric-symbols
     March 26, 2014 - September 14, 2022 WebM&M Cases Saline Flush Leads to … August 5, 2020 Incorrect use of smart infusion pump in the operating room (OR) leads

206. Operations Center: Operational Framework – Option Year 2 (pdf file)
     digital.ahrq.gov/sites/default/files/Operations%20Center%20OY2%20Operational%20Framework_508.pdf
     July 23, 2025 - Management Meeting To discuss project management for the overall project Project Management and Task Leads … Project Directorate CDSiC Operations Center Leadership Workgroup and Innovation Core Leads … They will receive interim update presentations by Workgroup Leads and Innovation Core Leads. … As such, Steering Committee members will: ■ Receive update presentations by Workgroup Leads and Innovation … Core Leads ■ Review and provide input on select products as requested by the Operations Center leadership

207. Operations Center: Operational Framework – Option Year 2 (pdf file)
     cdsic.ahrq.gov/sites/default/files/2025-03/Operations%20Center%20OY2%20Operational%20Framework_508.pdf
     January 01, 2025 - Management Meeting To discuss project management for the overall project Project Management and Task Leads … Project Directorate CDSiC Operations Center Leadership Workgroup and Innovation Core Leads … They will receive interim update presentations by Workgroup Leads and Innovation Core Leads. … As such, Steering Committee members will: ■ Receive update presentations by Workgroup Leads and Innovation … Core Leads ■ Review and provide input on select products as requested by the Operations Center leadership

208. CDSiC Stakeholder Community and Outreach Center: Quarterly Report (pdf file)
     digital.ahrq.gov/sites/default/files/Stakeholder%20Center%20Quarterly%20Report%20One_Jan26.pdf
     June 01, 2022 - , AHRQ project officers, the CDSiC PI and Co-Investigators, and Workgroup Chairs and Associate Leads … All eight Workgroup leads and 37 Workgroup members attended the meeting. … Workgroup Product Development Process Starting in January 2022, Workgroup leads generated up to … Following the meeting, Workgroup leads worked the Stakeholder Center support team to further refine … As products are developed, Workgroup leads will solicit and incorporate input from Workgroup members

209. Survey on LASA drug name pairs: who knows what’s on your list and the best ways to prevent mix-ups? | PSNet
     psnet.ahrq.gov/issue/survey-lasa-drug-name-pairs-who-knows-whats-your-list-and-best-ways-prevent-mix-ups
     June 10, 2018 - November 3, 2021 The absence of a drug–disease interaction alert leads to a child's death … January 23, 2019 Misprogramming PCA concentration leads to dosing errors.

210. OY1 Innovation Center Operational Framework (pdf file)
     cdsic.ahrq.gov/sites/default/files/2024-02/2_OY1%20Innovation%20Center%20Operational%20Framework.pdf
     January 01, 2024 - will work in partnership with Core 1 co-lead Dean Sittig (University of Texas Health) and Core 2 co-leads … Core co-leads will circulate a draft agenda and materials (e.g., background documents) at least one … Planning Committee, and AHRQ of Center and Core activities Team Support Staff Work with Core Co-leads … Leadership will join Workgroup meetings to obtain direct feedback on products and engage Workgroup Leads

211. Error | PSNet
     psnet.ahrq.gov/taxonomy/term/3475
     September 15, 2025 - Error An act of commission (doing something wrong) or omission (failing to do the right thing) that leads

212. Final Innovation Center Operational Framework (pdf file)
     cdsic.ahrq.gov/sites/default/files/2022-04/Final%20Innovation%20Center%20Operational%20Framework_508.pdf
     January 01, 2022 - will work in partnership with the Innovation Center Core 1 Lead Dean Sittig (UTHealth) and Core 2 Co-leads … Core co-leads will circulate a draft agenda and materials (e.g., slide decks, background documents) … Planning Committee, and AHRQ of Center and Core activities Team Support Staff ■ Work with Core Co-leads … Leadership will join workgroup meetings to obtain direct feedback on products and engage Workgroup Leads

213. OY1 Innovation Center Operational Framework (pdf file)
     digital.ahrq.gov/sites/default/files/2_OY1%20Innovation%20Center%20Operational%20Framework.pdf
     November 03, 2023 - will work in partnership with Core 1 co-lead Dean Sittig (University of Texas Health) and Core 2 co-leads … Core co-leads will circulate a draft agenda and materials (e.g., background documents) at least one … Planning Committee, and AHRQ of Center and Core activities Team Support Staff Work with Core Co-leads … Leadership will join Workgroup meetings to obtain direct feedback on products and engage Workgroup Leads

214. Final Innovation Center Operational Framework (pdf file)
     digital.ahrq.gov/sites/default/files/Final%20Innovation%20Center%20Operational%20Framework_508.pdf
     April 06, 2022 - will work in partnership with the Innovation Center Core 1 Lead Dean Sittig (UTHealth) and Core 2 Co-leads … Core co-leads will circulate a draft agenda and materials (e.g., slide decks, background documents) … Planning Committee, and AHRQ of Center and Core activities Team Support Staff ■ Work with Core Co-leads … Leadership will join workgroup meetings to obtain direct feedback on products and engage Workgroup Leads

215. Siegel, Corey | Digital Healthcare Research
     digital.ahrq.gov/principal-investigator/siegel-corey
     January 01, 2023 - Siegel, Corey Crohn's disease shared decision making intervention leads … Crohn's disease shared decision making intervention leads to more patients choosing combination therapy

216. Guide for Developing a Community-Based Patient Safety Advisory Council | Agency for Healthcare Research and Quality
     www.ahrq.gov/research/findings/final-reports/advisorycouncil/adcouncil2.html
     April 01, 2018 - Recognizing that collaboration with their providers through patient-centered care leads to better self-management … Improving consumer satisfaction, which leads to stronger patient loyalty.

217. CDSiC Stakeholder Community and Outreach Center: Quarterly Report (pdf file)
     cdsic.ahrq.gov/sites/default/files/2023-02/Stakeholder%20Center%20Quarterly%20Report%20Three_508_Jan26.pdf
     January 01, 2023 - , AHRQ project officers, the CDSiC PI and Co-Investigators, and Workgroup Co-leads. … The Workgroup support team has developed a draft taxonomy and the Workgroup leads presented the draft … In collaboration with Workgroup leads, the team is mapping out the actors within the integrated health … Workgroup leads presented an initial data flow diagram of the integrated health IT ecosystem to the … To illustrate this, the Workgroup support team and leads have developed an information flow model to

218. CDSiC Stakeholder Community and Outreach Center: Quarterly Report (pdf file)
     digital.ahrq.gov/sites/default/files/Stakeholder%20Center%20Quarterly%20Report%20Three_508_Jan26.pdf
     September 01, 2023 - , AHRQ project officers, the CDSiC PI and Co-Investigators, and Workgroup Co-leads. … The Workgroup support team has developed a draft taxonomy and the Workgroup leads presented the draft … In collaboration with Workgroup leads, the team is mapping out the actors within the integrated health … Workgroup leads presented an initial data flow diagram of the integrated health IT ecosystem to the … To illustrate this, the Workgroup support team and leads have developed an information flow model to

219. Taxonomic Guidance for Remedial Actions (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol2/Thomadsen.pdf
     December 23, 2004 - The Madison Medical Taxonomy Following the leads of Norman, Rasmussen, van der Schaaf, and others, we … In this level, any box to which the path leads must be considered for possible contributions to the … A YES at the human error box also leads, via the circled C, to the human factors sub-subpath in Figure … Either a YES or NO at either box still leads to the enabling factors box and consideration of possible … For human failures, the path leads to the fourth tier of taxonomy and the human error sub-subpath.

220. The role of housestaff in implementing medication reconciliation on admission at an academic medical center. | PSNet
     psnet.ahrq.gov/issue/role-housestaff-implementing-medication-reconciliation-admission-academic-medical-center
     March 30, 2011 - March 30, 2011 An anesthesiology department leads culture change at a hospital system … March 2, 2011 An anesthesiology department leads culture change at a hospital system