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Showing results for "learned".

5341. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/40964/psn-pdf
      July 23, 2012 - Social capital and knowledge sharing: effects on patient safety. July 23, 2012 Chang C-W, Huang H-C, Chiang C-Y, et al. Social capital and knowledge sharing: effects on patient safety. J Adv Nurs. 2012;68(8):1793-803. doi:10.1111/j.1365-2648.2011.05871.x. https://psnet.ahrq.gov/issue/social-capital-and-knowledge-s…

5342. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/47412/psn-pdf
      October 31, 2018 - The systems approach at the sharp end. October 31, 2018 Cross SRH. The systems approach at the sharp end. Future Healthc J. 2019;5(3):176-180. doi:10.7861/futurehosp.5-3-176. https://psnet.ahrq.gov/issue/systems-approach-sharp-end Systems solutions are often focused on creating improvements at the organizational o…

5343. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/45936/psn-pdf
      March 08, 2017 - Using information from external errors to signal a "clear and present danger." March 8, 2017 ISMP Medication Safety Alert! Acute care edition. February 9, 2017;22:1-5. https://psnet.ahrq.gov/issue/using-information-external-errors-signal-clear-and-present-danger Monitoring external reports of error and harm can pr…

5344. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/46192/psn-pdf
      June 07, 2017 - Investigating the causes of adverse events. June 7, 2017 Sanchez JA, Lobdell KW, Moffatt-Bruce SD, et al. Investigating the Causes of Adverse Events. Ann Thorac Surg. 2017;103(6):1693-1699. doi:10.1016/j.athoracsur.2017.04.001. https://psnet.ahrq.gov/issue/investigating-causes-adverse-events Incident analysis enab…

5345. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/38081/psn-pdf
      September 24, 2008 - Making patients safer: nurses' responses to patient safety alerts. September 24, 2008 Lankshear A, Lowson K, Harden J, et al. Making patients safer: nurses’ responses to patient safety alerts. J Adv Nurs. 2008;63(6). doi:10.1111/j.1365-2648.2008.04741.x. https://psnet.ahrq.gov/issue/making-patients-safer-nurses-re…

5346. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/41491/psn-pdf
      June 27, 2012 - The importance of failing forward. All of us will fail and make mistakes, but how can they benefit us and our organizations? June 27, 2012 Hofmann PB. The importance of failing forward. All of us will fail and make mistakes, but how can they benefit us and our organizations? Healthcare executive. 2012;27(3):64, 66…

5347. Final Progress Report: Implementation of a Medication Reconciliation Toolkit to Improve Patient Safety (MARQUIS2) (pdf file)
      www.ahrq.gov/sites/default/files/2024-02/schnipper2-report.pdf
      January 01, 2024 - MARQUIS2 was designed to take the lessons learned from MARQUIS1 and apply them to a larger group of … these results, the team received funding to conduct a second study (MARQUIS2), taking the lessons learned … Several changes were made to the toolkit in response to lessons learned from MARQUIS1, including the … made several improvements to the implementation approach; again, these were made based on the lessons learned

5348. Final Progress Report: Helping Elders Include Quality in Health Plan Choice (pdf file)
      www.ahrq.gov/sites/default/files/2024-07/uhrig-report.pdf
      January 01, 2024 - retirees in their early sixties and the current practices, resources spent, challenges, and lessons learned … Refinement 4.2.1 Drafting the Materials To inform the consumer product development, we applied lessons learned … developing the Choose with Care consumer materials, we adhered to a variety of content and format lessons learned … Many of the lessons learned from developing and testing reporting formats for health plan quality should

5349. Implementation and Evaluation of an Automated Email Notification System for Results of Tests Pending at Discharge - Final Report (pdf file)
      digital.ahrq.gov/sites/default/files/docs/publication/r21hs018229-dalal-final-report-2012.pdf
      January 01, 2012 - Based on previous work we learned that to successfully implement HIT to address this issue, the technology … Design considerations of HIT intervention We incorporated lessons learned from a previous, unsuccessful … attempt at implementing a computerized results manager application at our institution.4 We learned … Lessons learned from implementation of a computerized application for pending tests at hospital discharge

5350. White Paper_Supplementing Systematic Review Findings With Healthcare System Data: Pilot Projects From the Agency for Healthcare Research and Quality Evidence-based Practice Center Program (pdf file)
      effectivehealthcare.ahrq.gov/sites/default/files/related_files/pilot-projects-supplementing-white-paper.pdf
      December 01, 2024 - The workgroup met monthly from 2022 to 2023 to discuss challenges and lessons learned from the pilot … ................................................................................... 10 4.1 Lessons Learned … Methods The Scientific Resource Center (SRC) for the AHRQ EPC Program summarized findings and lessons learned … Discussion 4.1 Lessons Learned To our knowledge, this is the first study to evaluate the use of U.S

5351. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/60721/psn-pdf
      July 21, 2020 - expanded their telehealth capabilities, augmented patient safety considerations, and generated lessons learned … opportunity for a recalibration, or restructuring, of UCD’s healthcare delivery that builds on the lessons learned … How did you expedite that transition and what were some of the lessons learned?   Dr. … What are some of the lessons learned about providing care this way, particularly in a rural environment

5352. The LifePoint National Quality Program Provides Structured Framework for Reducing Inpatient Harm | PSNet
      psnet.ahrq.gov/innovation/lifepoint-national-quality-program-provides-structured-framework-reducing-inpatient-harm
      February 26, 2025 - Critical Radiology Alert Process October 30, 2024 Quality improvement lessons learned

5353. Guide to Implementing and Sustaining a Program To Prevent CLABSI and CAUTI in the Intensive Care Unit Setting (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/implementation-guide.pdf
      April 01, 2022 - Guide to Implementing and Sustaining a Program To Prevent CLABSI and CAUTI in the Intensive Care Unit Setting AHRQ Safety Program for Intensive Care Units: Preventing CLABSI and CAUTI Guide to Implementing and Sustaining a Program To Prevent CLABSI and CAUTI in the Intensive Care Unit Setting Overv…

5354. Video to Improve Patient Safety: Clinical and Educational Uses | PSNet
      psnet.ahrq.gov/perspective/video-improve-patient-safety-clinical-and-educational-uses
      March 01, 2004 - Video to Improve Patient Safety: Clinical and Educational Uses Yan Xiao, PhD; Colin F. Mackenzie, MB, ChB; and F. Jacob Seagull, PhD | May 1, 2015  View more articles from the same authors. Citation Text: Xiao Y, Mackenzie CF, Seagull JF. Video to Improve Patient S…

5355. Affinity-Details-Coping-Staff-Challenges (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/takeheart/training/affinity-details-coping-staff-challenges.pdf
      September 16, 2020 - EVENT SUMMARY LEARNING COMMUNITY AFFINITY GROUP | SUMMARY AT-AT-GLANCE | 1 AFFINITY GROUP DETAILS AT-A-GLANCE Title Coping with Staffing Challenges in Today’s Cardiac Rehabilitation Programs September 16, 2020 Purpose • To provide an opportunity for peer-to-peer sharing related how CR programs are r…

5356. Event-Summary-Details-Maximizing-Physician-Buy-In (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/takeheart/training/event-summary-details-maximizing-physician-buy-in.pdf
      June 16, 2022 - EVENT SUMMARY LEARNING COMMUNITY AFFINITY GROUP | SUMMARY AT-AT-GLANCE | 1 AFFINITY GROUP DETAILS AT-A-GLANCE Title Maximizing Physician Support for Cardiac Rehabilitation June 16, 2022 Purpose • To share evidence-based insights and practical solutions that effectively engage with physicians and enc…

5357. Choosing a Patient Safety Organization (pdf file)
      pso.ahrq.gov/sites/default/files/wysiwyg/pso-brochure.pdf
      March 01, 2020 - Choosing a Patient Safety Organization Choosing a Patient Safety Organization Background You are committed to making healthcare safer and better for your patients. One of the challenges to achieving this goal is the concern that patient safety information that you or your organization create as part of the ca…

5358. Facilitator Guide: Build Your SSI Prevention Bundle (doc file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/cusp/science-of-safety-facguide.docx
      January 01, 2017 - Facilitator Guide: Build Your SSI Prevention Bundle Slide Title and Commentary Slide Number and Slide Title Slide Science of Safety and Identifying Defects in Care of Mechanically Ventilated Patients SAY: Today, we will give you an overview of the Science of Safety and identifying defects. Slide 1 Learning O…

5359. The National Action Alliance to Advance Patient Safety Summer Webinar Series - PowerPoint Presentation (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/action-alliance/public-action-alliance-slides-040323_LOCKED.pdf
      May 25, 2023 - OSHA,PSOs) • Alliance providing a central repository of lessons learned, best practices, harm events

5360. Visual Management Board Component Kit | Agency for Healthcare Research and Quality
      www.ahrq.gov/hai/tools/ambulatory-surgery/sections/sustainability/management/visual-comp-kit.html
      June 01, 2017 - Visual Management Board Component Kit Contents 1. Why Have a Visual Management Board? 2. Tips for Using a Visual Management Board 3. Plan-Do-Study-Act (PDSA) “Ramp”: Learn To Use a Visual Management Board 4. Visual Management Board Example: Elements You Can Use 5. Connections to Other Components 6. …