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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/learn/learn-facilitator-guide.docx
May 01, 2017 - AHRQ Safety Program for Perinatal Care
Learn About the Comprehensive Unit-Based Safety Program for Perinatal … Safety
Learn About the Comprehensive Unit-Based Safety Program for Perinatal Safety
SAY:
This module … Slide 5
SAY:
In addition to this Learn About CUSP module, the first program pillar includes the … following modules:
Assemble the Team/Engage Leadership
Understand the Science of Safety
Sensemaking and Learn … Slide 30
AHRQ Publication No. 17-0003-1-EF
May 2017
AHRQ Safety Program for Perinatal Care Learn
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/tools/applying-cusp/learn_from_defects.docx
December 01, 2017 - Learn From Defects Tool
AHRQ Safety Program for Surgery
Learn From Defects Tool – Perioperative Setting … Too few perioperative teams take the opportunity to learn how the defect happened at a systems level, … It shares a based-on-real-life story about a surgical safety team using the Learn From Defects tool to … AHRQ Safety Program for Surgery Learn From Defects—Perioperative 2
II. … Too few perioperative teams take the opportunity to learn how the defect happened at a systems level,
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/sensemaking/learn-from-defects-facilitator-guide.docx
May 01, 2017 - AHRQ Safety Program for Perinatal Care
Sensemaking and Learn From Defects for Perinatal Safety
Sensemaking … and Learn From Defects for Perinatal Safety
SAY:
The Sensemaking and Learn From Defects module of … Slide 2
SAY:
Some of the tools that will help CUSP teams identify and learn from defects include— … The Learn From Defects Form, which provides a standardized means to assess where defects occur and to … Sensemaking is a way for a L&D unit to learn from and prevent mistakes.
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ce.effectivehealthcare.ahrq.gov/hai/cusp/modules/learn/index.html
July 01, 2018 - Healthcare-Associated Infections Program
About the CUSP Method
Modules
Learn … the CUSP Method
Project Summary
How to Use CUSP
Content Calls
Modules
Learn … about CUSP
The Learn about CUSP module of the CUSP Toolkit offers an outline and brief history … Page last reviewed July 2018
Page originally created January 2013
Internet Citation: Learn … https://www.ahrq.gov/hai/cusp/modules/learn/index.html
Back to Top
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ce.effectivehealthcare.ahrq.gov/hai/cusp/toolkit/learn-defects.html
December 01, 2012 - Healthcare-Associated Infections Program
About the CUSP Method
Modules
Learn … the CUSP Method
Project Summary
How to Use CUSP
Content Calls
Modules
Learn … Defects Tool
CUSP Toolkit
Health care organizations can increase the extent to which they learn … Problem statement: Health care organizations can increase the extent to which they learn from defects … https://www.ahrq.gov/hai/cusp/toolkit/learn-defects.html
Back to Top
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ce.effectivehealthcare.ahrq.gov/hai/cusp/modules/learn/sl-cusp.html
December 01, 2012 - About CUSP
CUSP Toolkit
The Learn about CUSP module of the CUSP Toolkit offers an outline … Toolkit Modules
Learn About CUSP.
Assemble the Team.
Engage the Senior Executive. … Provide opportunities for staff to learn and practice using teamwork and communication tools. … Note: This module combines the CUSP steps Identify Defects and Learn from Defects . … Learn how Just Culture principles can augment CUSP.
Review key steps of the CUSP Toolkit .
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ce.effectivehealthcare.ahrq.gov/hai/cusp/modules/learn/fac-cusp.html
December 01, 2012 - About CUSP
Learn About CUSP, Facilitator Notes … Toolkit Modules
Learn About CUSP. Assemble the Team. Engage the Senior Executive. … Say:
The CUSP Toolkit's modules are the following:
Learn About CUSP.
Assemble the Team. … Note: This module combines the CUSP steps Identify Defects and Learn from Defects . … Learn how Just Culture principles can augment CUSP.
Review key steps of the CUSP Toolkit.
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ce.effectivehealthcare.ahrq.gov/talkingquality/plan/your-audience/learn-about.html
July 01, 2011 - Assess Your Reporting Project
Resources
About TalkingQuality
How To Learn … reviewed July 2011
Page originally created February 2015
Internet Citation: How To Learn … https://www.ahrq.gov/talkingquality/plan/your-audience/learn-about.html
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ce.effectivehealthcare.ahrq.gov/hai/cusp/videos/04e-learn-defects/index.html
June 01, 2018 - Healthcare-Associated Infections Program
About the CUSP Method
Videos
Learn … Reports
Videos
Decolonization – Universal and Targeted
Tools
Learn … Learn From Defects [2 min. 58 sec.] … Page last reviewed June 2018
Page originally created February 2013
Internet Citation: Learn … https://www.ahrq.gov/hai/cusp/videos/04e-learn-defects/index.html
Back
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/learn/learn-about-cusp.pptx
May 01, 2017 - AHRQ Safety Program for Perinatal Care: Learn About the Comprehensive Unit-based Safety Program
AHRQ … Safety Program for Perinatal Care
Learn About the Comprehensive
Unit-based Safety Program for
Perinatal … Safety
AHRQ Publication No. 17-0003-1-EF
May 2017
1
CUSP and Perinatal Safety
2
Learn About CUSP … 4
Learn About CUSP
AHRQ Safety Program for Perinatal Care
4
Safety Program for Perinatal Care
5 … Learn About CUSP
AHRQ Safety Program for Perinatal Care
SPPC CUSP Modules
Learn About CUSP
Assemble
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/modules/sustainability/sustainability_learn_from_defects.pptx
December 01, 2017 - PowerPoint Presentation: Learn From Defects for Sustainability
Sustainability: Learning From Defects … Dig into the literature to learn how others have faced similar defects. … Learn from defects on a regular basis. … A practical tool to learn from defects in patient care. … Learn From Defects ‹#›
AHRQ Safety Program for Surgery – Sustainability
25
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/lhs/how_learning_health_systems_learn.pdf
November 06, 2019 - How Learning Health Systems Learn: Lessons from the Field
Evidence
generators
Evidence
curators … curators
Evidence
adopters
Evidence
disseminators
Evidence
managers
How Learning Health
Systems Learn … :
Lessons from the Field
e
1
How Learning Health Systems Learn: Lessons from
the Field
A … AHRQ conducted site visits at a few leading organizations to learn about
the steps they have taken to
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/modules/implementation/imp_learn_from_defects.pptx
December 01, 2017 - PowerPoint Presentation: Learn From Defects Through Sensemaking
Learning From Defects
Through Sensemaking … 3
Standardize Care
Create Independent Checks
Learn From Defects
Problem-Solving Hierarchy … Asking people to read, learn, and apply the learning enables people to form memories of the process. … In the first month, you learn that only 15 out of 30 patients had the proper body temperature. … A practical tool to learn from defects in patient care.
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/learn/learn-about-cusp-facilitator-guide.pdf
May 01, 2017 - Learn About the Comprehensive Unit-Based Safety Program for Perinatal Safety
AHRQ Safety Program for … Perinatal Care
Learn About the Comprehensive Unit-Based Safety Program for Perinatal Safety
AHRQ … Slide 5
Learn About Comprehensive Unit-Based Safety Programs for Perinatal Safety
AHRQ Safety … Program for Perinatal Care Learn About CUSP 3
SAY:
In addition to this Learn About CUSP module, … Program for Perinatal Care Learn About CUSP 8
How were these at-risk behaviors
handled?
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ce.effectivehealthcare.ahrq.gov/hai/tools/mvp/modules/cusp/learn-from-defects-fac-guide.html
February 01, 2017 - Patients: Facilitator Guide
AHRQ Safety Program for Mechanically Ventilated Patients
Slide 1: Learn … This module focuses specifically on the fourth step, which is to learn from defects. … Asking people to read, learn, and apply the learning enables people to form memories of the process. … last reviewed February 2017
Page originally created February 2017
Internet Citation: Learn … https://www.ahrq.gov/hai/tools/mvp/modules/cusp/learn-from-defects-fac-guide.html
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/sensemaking/learn-from-defects-facilitator-guide.pdf
May 01, 2017 - and Learn From Defects for Perinatal Safety
AHRQ Publication No. 17-0003-5-EF
May 2017
SAY:
The … Care
Sensemaking &
Learn From Defects 2
• The Learn From Defects Form, which
provides a standardized … Sensemaking is a way for a L&D unit to learn
from and prevent mistakes. … Care
Sensemaking &
Learn From Defects 12
• Step 2. … &
Learn From Defects 14
SAY:
After working through the Sensemaking and
Learn From Defects processes
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ce.effectivehealthcare.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/long-term-modules/module2/defects.html
March 01, 2017 - Infections Program
Tools
Reduce CAUTI in LTC Facilities
Toolkit Sections
Learn … Ambulatory Settings
Telemedicine
Universal ICU Decolonization Protocol
Learn … Page last reviewed March 2017
Page originally created March 2017
Internet Citation: Learn
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/sensemaking/sensemaking.pptx
May 01, 2017 - AHRQ Safety Program for Perinatal Care: Monitoring for Perinatal Safety: Sensemaking and Learn from Defects … AHRQ Safety Program for Perinatal Care
Sensemaking and Learn From Defects for Perinatal Safety
AHRQ … 0003-5-EF
May 2017
1
Learning Objectives
2
AHRQ Safety Program for Perinatal Care
Sensemaking &
Learn … Model
4
AHRQ Safety Program for Perinatal Care
Sensemaking &
Learn from Defects
Identify Defects … from Defects
19
Summary: Sensemaking and Learn From Defects
Sensemaking and Learn From Defects share
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ce.effectivehealthcare.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/modules/sustainability/sustainability_learn_from_defects_facnotes.docx
December 01, 2017 - Accessible Facilitator Guide: Learn From Defects for Sustainability
Slide Title and Commentary
Slide … Dig into the literature to learn how others have faced similar defects. … Keep in mind the principles of safe design:
· Standardize care
· Create independent checks
· Learn from … That momentum will help your team learn from more complex defects and garner resources to address them … Learn from defects on a regular basis.
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ce.effectivehealthcare.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/teamwork/learn-from-defects-fac-guide.html
July 01, 2023 - The Learn From Defects Form, which provides a standardized means to assess where defects occur and to … Sensemaking is a way for a L&D unit to learn from and prevent mistakes. … Further guidance to complete this exercise can be found using the CUSP Learn From Defects form. … Create a one-page summary answering the four Learn From Defects questions. … Engage staff in face-to-face conversations to provide opportunities to learn from defects.