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Showing results for "lessons learned".

3041. TeamSTEPPS® Diagnosis Improvement: Module 1 Introduction (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/teamstepps-program/dx-improvement/module1-presenters-notes.pdf
      January 12, 2022 - transparency and disclosure of diagnostic errors, focus on learning from diagnostic events, and disseminate lessons … ongoing teamwork TeamSTEPPS is an evidence‐based teamwork system based on 20 years of experience and lessons … • Teamwork is not innate; it must be learned. … This skill improvement is important because teamwork is not innate; it must be learned. … Kane’s case will be used to discuss and reinforce TeamSTEPPS principles, lessons, and tools and how

3042. Medical Team Training Programs in Health Care (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol4/Baker.pdf
      February 01, 2005 - training content. 4.5 0.60 4.5 0.59 4.6 0.65 I am confident that I can use the knowledge that I learned … Navy, produced a number of useful tools and lessons learned that are applicable to health care.35 Based … A successful transfer of lessons learned in aviation psychology and flight safety to health care: the … Developing and evaluating an interdisciplinary clinical team training program: lessons learned and … lessons taught.

3043. Accessing the Cutting Edge: Implementing HIT to Improve Quality in Rural East Kern Count - Final Report (pdf file)
      digital.ahrq.gov/sites/default/files/docs/publication/uc1hs016146-nocella-final-report-2009.pdf
      January 01, 2009 - There were many valuable lessons learned through the process of adoption and utilization of Health IT … Some lessons include building the option to push selected data collected from the HIE into the existing … This was an important lesson learned in the project and may have implications for future HIE projects … A summary of the various lessons learned during the EKCITA HIE project is below: • Initial fears include … A summary of lessons learned from the rural tele-ophthalmology demonstration is provided below.

3044. Perspectives on Implementing Quality Improvement Collaboratives Effectively: Qualitative Findings from the CHIPRA Quality Demonstration Grant Program (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/policymakers/chipra/demoeval/what-we-learned/perspectives-quality-improvement-collaboratives.pdf
      January 01, 2018 - • What lessons have you learned or what insights and advice might you have for other states trying to … • Summary Table of Activities Performed over the Past Six Months with Grant Funding • Key Lessons … Learned & Our Ah-ha! … Some states learned that not setting specific expectations led to poor practice engage­ ment (IL, NC … 13, 2017. http://www.ahrq.gov/sites/ default/files/wysiwyg/policymakers/chipra/demoeval/ what-we-learned

3045. The Soil, Not the Seed: The Real Problem with Root Cause Analysis | PSNet
      psnet.ahrq.gov/perspective/soil-not-seed-real-problem-root-cause-analysis
      March 01, 2007 - The focus is on individuals, rules, and sanctions; therefore, lessons learned are not shared.

3046. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/35092/psn-pdf
      November 30, 2007 - He proposes that the medical profession can learn valuable lessons from the engineering safety culture

3047. Toolkit 1. Suspected UTI SBAR Toolkit (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/nhguide/4_TK1_T4-Urinalysis_and_UTIs_Improving_Care-updated.pdf
      October 01, 2016 - Toolkit 1. Suspected UTI SBAR Toolkit Nursing Home Antimicrobial Stewardship Guide Determine Whether To Treat Toolkit 1. Suspected UTI SBAR Toolkit Tool 4. Training Modules: Urinalysis and UTIs Improving Care Overview These training modules are designed to be flexible to meet your needs. Training coord…

3048. Using Machine Learning to Improve Patient Safety in the Home or Remote Setting for Adults. | PSNet
      psnet.ahrq.gov/issue/using-machine-learning-improve-patient-safety-home-or-remote-setting-adults
      May 25, 2022 - November 3, 2015 Findings and Lessons From the Improving Management of Individuals With

3049. Implementing an Ambulatory Electronic Medical Record and Improving Shared Access - FInal Report (pdf file)
      digital.ahrq.gov/sites/default/files/docs/publication/uc1hs016128-deluca-final-report-2009.pdf
      January 01, 2009 - After several clinic implementations, the team learned that the manual was overwhelming to the users … We learned during the pilot clinic’s training, that it was detrimental to their learning to have the … Whether organizations are implementing the same software as SBL or another vendor’s solution, our lessons … learned will be valuable. … The recipe was enhanced as lessons were learned with each individual implementation.

3050. Planning Grants Final Evaluation Report: Longitudinal Evaluation of the PSML Reform Demonstration Program (pdf file)
      www.ahrq.gov/sites/default/files/publications/files/psml-planning-grants-final-report.pdf
      May 01, 2016 - it was anticipated that the planning grants would result solely in preliminary findings, primarily lessons … learned. … learned. … learned. … Implementing near-miss reporting and improvement tracking in primary care practices: Lessons learned

3051. Planning Grants Final Evaluation Report: Longitudinal Evaluation of the PSML Reform Demonstration Program (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/candor/psml-planning-grants-final-report.pdf
      May 01, 2016 - it was anticipated that the planning grants would result solely in preliminary findings, primarily lessons … learned. … learned. … learned. … Implementing near-miss reporting and improvement tracking in primary care practices: Lessons learned

3052. Chapter 1. The Framework for Improvement | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/settings/hospital/vtguide/guide1.html
      February 01, 2016 - Answering key questions about the landscape, available data, lessons learned, and barriers and opportunities … Identify Lessons Learned Many VTE prevention efforts fail because of a lack of standardized guidance … Are there any major lessons from previous or ongoing interventions to prevent VTE?

3053. Chapter 1. The Framework for Improvement | Agency for Healthcare Research and Quality
      www.ahrq.gov/es/patient-safety/settings/hospital/vtguide/guide1.html
      February 01, 2016 - Answering key questions about the landscape, available data, lessons learned, and barriers and opportunities … Identify Lessons Learned Many VTE prevention efforts fail because of a lack of standardized guidance … Are there any major lessons from previous or ongoing interventions to prevent VTE?

3054. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/33671/psn-pdf
      July 01, 2008 - The focus is on individuals, rules, and sanctions; therefore, lessons learned are not shared.

3055. 09-0071-Ef 1 (pdf file)
      digital.ahrq.gov/sites/default/files/docs/page/09-0071-EF_1.pdf
      June 01, 2009 - Liability Coverage for Regional Health Information Organizations Lessons from the AHRQ-Funded State … learned from AHRQ’s portfolio of Health IT projects. … The primary purpose of this report is to share lessons learned from the field on the key considerations … LEARNED............................................................................................. … As a summary of the various lessons learned, the following key steps to acquiring an insurance policy

3056. AHRQ Issue Brief: Understanding the AI Wave: Foundational Knowledge for Improving Diagnosis and Beyond (pdf file)
      www.ahrq.gov/sites/default/files/wysiwyg/diagnostic/resources/issue-briefs/dxsafety-brief-ai-wave.pdf
      June 01, 2025 - Moving Forward.....................................................................................10 Lessons … Like the toddler misclassifying the red block, the model has learned the wrong rule. … Insights from other high-risk industries that have successfully adapted to automation offer valuable lessons … into high-risk environments—such as aviation, nuclear power, and manufacturing—offer important lessons … As healthcare moves to integrate AI more deeply into clinical care, applying these lessons requires

3057. Project Report - Lean Sigma (ppt file)
      www.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/cusptoolkit/toolkit/contentcalls/nurse_empower-slides/How-CUSP-Enables-Nurse-Empowerment-Nov-15-2011-508.ppt
      January 01, 2011 - leadership team * Slide * SICU Huddle Board * Slide * Surgical Unit Huddle Board Slide * Lessons … Administrator tries to “solve” problem rather than listen Being afraid of airing dirty laundry * Slide * Lessons

3058. How To: Collaborate with Patients on Patient-Centered Clinical Decision Support (pdf file)
      cdsic.ahrq.gov/sites/default/files/2025-09/Collaborate%20with%20Patients%20How%20To%20Guide_Final%208.27.25.pdf
      January 01, 2025 - into overcoming the challenges faced when implementing and scaling PC CDS, this report aggregates lessons … learned from nine AHRQ-funded PC CDS projects, offering a comprehensive overview of the key obstacles … common challenges such as EHR integration, data interoperability, and user adoption, leveraging the lessons … learned from AHRQ-funded projects.

3059. Chapter 3. Developing Change: Designing the Medication Reconciliation Process | Agency for Healthcare Research and Quality
      www.ahrq.gov/es/patient-safety/settings/hospital/match/chapter-3.html
      July 01, 2022 - Chapter 3 Lessons Learned Lessons learned from staff of facilities that have implemented MATCH and

3060. Chapter 3. Developing Change: Designing the Medication Reconciliation Process | Agency for Healthcare Research and Quality
      www.ahrq.gov/patient-safety/settings/hospital/match/chapter-3.html
      July 01, 2022 - Chapter 3 Lessons Learned Lessons learned from staff of facilities that have implemented MATCH and