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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol1/Hoff.pdf
January 01, 2003 - Implementing Safety Cultures in Medicine: What We Learned by Watching Physicians
15
Implementing … particular around how the near miss or mistake is being
conceptualized by the individual and the larger lessons … to
be learned from it. … to compare and contrast different mistake
situations with each other, creating more generalizable
lessons … On mistake management: lessons from
aviation. BMJ 2000 March;320:781–5.
27.
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www.ahrq.gov/patient-safety/settings/hospital/candor/modules/facguide3/apb.html
August 01, 2022 - Are claims and lawsuits tracked and analyzed for lessons learned?
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www.ahrq.gov/es/patient-safety/settings/hospital/match/intro.html
July 01, 2022 - In addition to elements from the MATCH Web site, this toolkit also incorporates the experiences and lessons … learned of facilities that have implemented MATCH and facilities that received technical assistance
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www.ahrq.gov/patient-safety/settings/hospital/match/intro.html
July 01, 2022 - In addition to elements from the MATCH Web site, this toolkit also incorporates the experiences and lessons … learned of facilities that have implemented MATCH and facilities that received technical assistance
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www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/demoeval/what-we-learned/highlight05.pdf
September 08, 2015 - The smaller health systems are
meant to benefit from lessons learned by
their predecessors. … CHIPRA demonstration staff are the
main vehicles for imparting lessons.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/cusptoolkit/modules/spread/spreadnotes.docx
June 02, 2025 - Essentially, knowledge management and knowledge transfer explore taking lessons learned in one unit and … transferring those lessons to other units to create better ideas that fit with the social system. … significantly—should wait to put the new process in place so they can benefit from the data collected and the lessons … learned by the units that adopted the process earlier..
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www.ahrq.gov/policymakers/chipra/demoeval/what-we-learned/final-report/section4.html
October 01, 2015 - developed and disseminated evaluation findings throughout the evaluation period, emphasizing emerging lessons … learned about program implementation at first and synthesizing findings about program outcomes and effects
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www.ahrq.gov/evidencenow/projects/state/how-to-guide/guide4.html
August 01, 2024 - to learn from one another; build peer support and community; and share strategies, challenges, and lessons … learned for QI implementation. … The AHRQ website includes valuable resources for practice facilitators along with lessons learned … Among these lessons, evaluators found that effective practice facilitators use a combination of the
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/perinatal-care-2/hypertension_8_program-evaluation.pptx
July 01, 2023 - three domains:
LEARNING: assess knowledge, attitudes, and behaviors
TRANSFER: assess application of learned … of successful program implementation
Reports and publications will be generated to disseminate the lessons … learned
22
Hospital AIM Team
Leads
SPPC-II
SCRIPT
And finally, we want to share some key consideration … of successful program implementation
Reports and publications will be generated to disseminate the lessons … learned
22
Thank you!
-
www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/perinatal-care-2/hemorrhage_8_program-evaluation.pptx
July 01, 2023 - three domains:
LEARNING: assess knowledge, attitudes, and behaviors
TRANSFER: assess application of learned … of successful program implementation
Reports and publications will be generated to disseminate the lessons … learned
22
Hospital AIM Team
Leads
SPPC-II
SCRIPT
And finally, we want to share some key consideration … of successful program implementation
Reports and publications will be generated to disseminate the lessons … learned
22
Thank you!
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www.ahrq.gov/funding/grantee-profiles/grtprofile-gonzales.html
October 01, 2024 - This time, he worked to translate some of the lessons learned from primary care practices and apply them
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www.ahrq.gov/hai/tools/mvp/modules/cusp/assess-psc-hsop-slides.html
February 01, 2017 - Improving safety culture results in Rhode Island ICUs: lessons learned from the development of action-oriented … Improving safety culture results in Rhode Island ICUs: lessons learned from the development of action-oriented
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www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/demoeval/what-we-learned/highlight07.pdf
September 08, 2015 - and feel more
stress than other caregivers.2,3 Through
peer support programs, caregivers who
have learned … The strategies
used by these States and the early
lessons they have learned may be
helpful for other … States have
also learned that peer support caregivers
themselves lead a complex life. … developing or
expanding peer support programs
for caregivers of CSHCN may want
to consider the following lessons … learned by the CHIPRA quality
demonstration States:
• Carefully defining the peer support
caregiver
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www.ahrq.gov/patient-safety/settings/hospital/candor/demo-program/grants/summary.html
August 01, 2022 - Summary
Detailed Findings
Evaluation Issues
Contributions to Patient Safety and Medical Liability
Lessons … Learned From Implementation Challenges
Followup to the PSML Demonstration Projects
Recommendations … This final evaluation report highlights the most substantive findings and lessons learned by the seven … findings) and an expanded description of the findings, our independent assessment of the findings, and lessons … learned follow in the full report and the individual grantee profiles in Appendix A .
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/pdi/g1_pdi_availablecomprehensiveqiguides.pdf
June 02, 2025 - The material has been influenced by lessons learned from hands-on field experience at Army
MTFs that
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www.ahrq.gov/news/blog/ahrqviews/strengthen-primary-care.html
October 01, 2024 - State-Based Infrastructure To Support Primary Care Quality Improvement , highlights effective approaches and lessons … learned from AHRQ initiatives designed to provide external quality improvement support for primary care
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/g1_combo_availablecomprehensiveqiguides.pdf
June 02, 2025 - The material has been influenced by lessons learned from hands-on field experience at Army
MTFs that
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www.ahrq.gov/hai/tools/ambulatory-surgery/sections/sustainability/management/observation-slides.html
June 01, 2017 - out the specifications of your test
Do: Conduct the test
Study: Review how the test went and lessons … learned
Act: Integrate your learning into your next test or into daily practice
Image: PDSA Ramp
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www.ahrq.gov/ncepcr/research-transform-primary-care/transform/profile/solberg.html
April 01, 2015 - Lessons Learned and Implications for Others
Findings indicated that there was not an abrupt change
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www.ahrq.gov/evidencenow/projects/state/how-to-guide/using-guide.html
August 01, 2024 - The guide includes effective approaches, lessons learned, and example materials from the Agency for Healthcare