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421. Final Progress Report: Gastrointestinal Safety of Antithrombotic Drug Regimens (pdf file)
     www.ahrq.gov/sites/default/files/2024-01/abraham-report.pdf
     January 01, 2024 - coronary syndrome using administrative data, studying heterogeneity of risks, and comparing machine learning … and validate a highly sensitive algorithm for predicting antithrombotic- related GIB using machine learning … In this grant, we quantified risk, studied risk factors, and used machine learning techniques to derive … In Aim #3, we used machine learning techniques to derive and validate an antithrombotic-related GIB … What are the new findings: The examined machine learning models (regularized Cox regression [RegCox

422. Summary of Survey Findings | Agency for Healthcare Research and Quality
     www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-culture-survey-brazil-summary.html
     August 01, 2024 - Learning from AHRQ's Diagnostic Safety Culture Survey at a Tertiary Care Health System in Brazil: A Case … Study Summary of Survey Findings Previous Page Next Page Table of Contents Learning … institution in routinely providing specific feedback when a diagnosis is missed or incorrect, limiting learning

423. Half-Day Training Content | Agency for Healthcare Research and Quality
     www.ahrq.gov/teamstepps-program/curriculum/communication/teach/half-day.html
     May 01, 2023 - Continue to foster mutual respect, fun, and transparency through the use of active learning and listening … Introduction and Objectives Briefly review the learning objectives for the module (Slide 2) and then … Using groups to brainstorm challenges to communication in conjunction with Slide 8 will help make the learning

424. Imaging-Quality-Long-Desc
     www.ahrq.gov/patient-safety/resources/learning-lab/imaging-quality-long-desc.html
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425. Failure-Rescue-Long-Desc
     www.ahrq.gov/patient-safety/resources/learning-lab/failure-rescue-long-desc.html
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426. Brain-Health-Long-Desc
     www.ahrq.gov/patient-safety/resources/learning-lab/brain-health-long-desc.html
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427. Design-Environments-Long-Desc
     www.ahrq.gov/patient-safety/resources/learning-lab/design-environments-long-desc.html
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428. Apply Module Slide Presentation Text Descriptions | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/cusp/modules/apply/alt-text.html
     March 01, 2013 - Slide 2 Learning Objectives Introduce Just Culture principles Learn how Just Culture principles … System Design Mission, Values, and Expectations Behavioral Choices Improved Outcomes Learning … Learning systems, like mission, values, and expectations, affect system design and in turn, behavioral … employees to follow Ensure employees are properly trained Offer positive reinforcement at the monthly Learning … should: Share summaries of defects within the organization Engage staff in conversations to enhance Learning

429. Assemble the Team | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/cusp/modules/assemble/team-slides.html
     December 01, 2012 - Learning Objectives . Slide 3. The Unit-Based CUSP Team . Slide 4. CUSP Team Members . … Learning Objectives] Understand the importance of your CUSP team. … members feel that their environment supports the interpersonal risk involved in asking for help or learning … Promote active listening and learning from each other. Ensure all team members are accessible. … Managing the Risk of Learning: Psychological Safety in Work Teams. In West M, ed.

430. Supplement to Evaluation Highlight No. 6 | Agency for Healthcare Research and Quality
     www.ahrq.gov/policymakers/chipra/demoeval/what-we-learned/supplhighlight06.html
     January 01, 2014 - This tri-State partnership conceptualizes its work as a State-level learning collaborative through which … each partner deliberately structures its activities to promote collective learning, planning, and problem … Child-serving practices in the three States are participating in practice-level learning collaboratives … These three States are working together as a State-level learning collaborative in order to implement … Practice facilitators in both States participate in shared learning activities, including Webinars, interactive

431. Implementing Heart Health Practice Self-Assessment (doc file)
     www.ahrq.gov/sites/default/files/wysiwyg/evidencenow/tools-and-materials/skills-qi-heart-health.docx
     February 01, 2016 - Additional specific references are available through the online HVH Learning Community. · · Agency for … We have a defined strategy for supporting organizational learning for quality improvement and practice … Invest in provider and staff learning about E&M coding 2. … a “…continuously learning health system, one that aligns science and informatics, patient-clinician … Support team learning about community health needs and implications for quality improvement, scope of

432. Methods To Deploy Training | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/quality/tools/cauti-ltc/methods-to-deploy.html
     March 01, 2017 - Self-Guided Learning . … If you have a learning management system (LMS), the video and discussion guide can be added to your LMS

433. Sensemaking and Learn from Defects for Perinatal Safety (pdf file)
     www.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 - By engaging in this learning process, providers can uncover contributing system-level failures that … From Defects 7 SAY: The following tools can be used to help engage unit staff in identifying and learning … SAY: Learning from defects often reveals that systems contribute to the underlying causes of the defects … Learning from defects can also be called second-order problem solving. … Slide 19 SAY: In summary— • Sensemaking and Learning From Defects share several common themes.

434. Leveraging Cultural Change to Reduce Urinary Catheter Use | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/cauti-tools/archived-webinars/leveraging-cultural-change-slides.html
     December 01, 2017 - Slide 2 Learning Objectives Describe the way in which improvement in the clinical culture can … focused implementation – implementation at unit level Frontline staff engagement Organizational learning … Four Components of Safety Culture Reporting Culture Just Culture Flexible (Teamwork) Culture Learning … component of safety culture Image: Pyramid with the following layers from top to bottom: HRO, Learning … Assessment Identify areas of culture in need of improvement: Identify impairments in organizational learning

435. Coping-Staff-Challenges-Slides (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/takeheart/training/coping-staff-challenges-slides.pdf
     June 02, 2025 - will begin this November  Ongoing offerings of affinity group sessions on priority topics for the learning … Events are open to anyone but participants are encouraged to join the TAKEheart Learning Community …  Purpose of Today’s Call:  Continue process of learning and sharing with each other  Focus of today

436. The Comprehensive Unit-based Safety Program (CUSP) for MRSA Prevention | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/tools/mrsa-prevention/toolkit/cusp.html
     October 01, 2024 - CUSP Psychological Safety Learning From Defects Evaluating and Sustaining Progress Index of CUSP … Learning From Defects A "defect" is defined as "Anything that you don't want to have happen again." … Learning from defects and adapting your system is crucial to preventing the defect from reoccurring.

437. The Comprehensive Unit-based Safety Program (CUSP) for MRSA Prevention | Agency for Healthcare Research and Quality
     www.ahrq.gov/hai/tools/mrsa-prevention/surgery/cusp-mrsa-prevention.html
     April 01, 2025 - Learning From Defects This section delves deeper into the Learning From Defects CUSP tool. … This tool is helpful for learning from any adverse event that happens and using that “defect” to drive

438. The Agency for Healthcare Research and Quality’s Initiative to Identify and Support the Needs of Primary Care Practice-Based Research Networks (PBRNs) (pdf file)
     www.ahrq.gov/sites/default/files/wysiwyg/ncepcr/pbrn/pbrn_technical_expert_panel_report_2025.pdf
     January 01, 2025 - e-learning course to support and promote the work of PBRNs. … ” · Learning Series Topic Brainstorm: ○ “Resources for new PBRNs. … webinars and an e-learning course. … improvement, including shared learning and resources among PBRNs. … Additional Activity Identify ways to increase awareness of webinars and e-learning.

439. 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 - A Playbook for Preventing CLABSI and CAUTI in the ICU Setting CLABSI and CAUTI Learning Tools: CLABSI … CLABSI Event Reporting Tool CAUTI Event Reporting Tool The Learning From Defects tools support a … http://www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/cauti-learning-from-defects.docx … in the ICU Setting: Connecting the Dots Between CUSP and the Tiered Interventions CLABSI and CAUTI Learning … Tools: CLABSI/CAUTI Event Reporting Tools and CLABSI/CAUTI Learning From Defects Tools APIC HAI Calculator

440. Learn About the Comprehensive Unit-Based Safety Program for Perinatal Safety (pdf file)
     www.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 - Learning systems; and 5. Accountability and justice. … Slide 20 SAY: Learning systems By establishing learning systems, organizations can manage both systems … communication tools that can be used to promote learning systems. … Third, offer positive reinforcement at the monthly Learning From Defects meeting. … The Learning From Defects process is an effective way to instill or reinforce learning systems that