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Total Results: 4,019 records

Showing results for "mistakes".

  1. The Role of the Patient in Improving Patient Safety | PSNet

    psnet.ahrq.gov/perspective/role-patient-improving-patient-safety
    March 01, 2007 - Edwards Deming, said in his book, Out of the Crisis , "Customers would be eager to work...to reduce mistakes … the hospital and the family can share the story together, and hopefully people can learn from their mistakes

  2. In Conversation With... John G. Reiling, PhD | PSNet

    psnet.ahrq.gov/perspective/conversation-john-g-reiling-phd
    June 01, 2014 - It is important to try to understand cognitive functioning, why people make mistakes, and what are the … conditions in which they won't make as many mistakes.

  3. Engage the Team and Applying CUSP in the ICU Setting Slides (doc file)

    www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/cusp-icu-notes.docx
    April 01, 2022 - Errors often occur because systems frequently are not designed to catch mistakes before they reach the … someone to be more careful is a far weaker intervention because humans are fallible and are bound to make mistakes

  4. PSNet Curated Library (pdf file)

    psnet.ahrq.gov/print/pdf/node/866100
    August 30, 2023 - Fatigue is known to contribute to mistakes and omissions in nursing care. … Fatigue is known to contribute to mistakes and omissions in nursing care.

  5. Implementation of Patient Safety Projects | PSNet

    psnet.ahrq.gov/curated-library/implementation-patient-safety-projects
    August 10, 2025 - Harvard Business School, outlines the eight stages of a successful change process, as well as common mistakes … These mistakes include not...

  6. Creating an Improvement Culture (pdf file)

    www.ahrq.gov/sites/default/files/wysiwyg/cahps/news-and-events/podcasts/Creating_an_Improvement_Culture_2011_10_01_Transcript.pdf
    January 01, 2011 - The data shows that organizations that are this size and this complex are going to make mistakes. … But when mistakes are made, if the organization demonstrates that they’re sorry, they make it up to the

  7. Algorithm-Based Decision Support System Guides Trauma Staff During Initial Treatment, Leading to Fewer Medical Errors | PSNet

    psnet.ahrq.gov/innovation/algorithm-based-decision-support-system-guides-trauma-staff-during-initial-treatment
    May 31, 2023 - , the program reduced overall medical errors, along with the incidence of several specific types of mistakes … medical errors had not been made, with the ED phase of care being responsible for the greatest number of mistakes

  8. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33877/psn-pdf
    April 01, 2019 - It has moved to include supporting physicians when mistakes happen but way beyond that.

  9. In Conversation With… Christine Cassel, MD | PSNet

    psnet.ahrq.gov/perspective/conversation-christine-cassel-md
    February 26, 2025 - The patient safety world is all about measuring when mistakes or bad things happen.

  10. Medication Administration Errors | PSNet

    psnet.ahrq.gov/primer/medication-administration-errors
    December 15, 2024 - Medication Administration Errors Citation Text: MacDowell P, Cabri A, Davis M. Medication Administration Errors. PSNet [internet]. Rockville (MD): Agency for Healthcare Research and Quality, US Department of Health and Human Services. 2021. Copy Citation Format: Google Scholar BibTeX EndNote X…

  11. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33648/psn-pdf
    March 01, 2007 - the hospital and the family can share the story together, and hopefully people can learn from their mistakes

  12. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/836812/psn-pdf
    March 30, 2022 - that contribute to patient safety problems, while avoiding blame setting or focusing on individual mistakes

  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33799/psn-pdf
    January 01, 2015 - likely to subjectively rate patient safety lower in their organizations and to admit to having made mistakes

  14. Overview of the Comprehensive Unit-based Safety Program for Application to Mechanically Ventilated Patients: Slide Presentation | Agency for Healthcare Research and Quality

    www.ahrq.gov/hai/tools/mvp/modules/cusp/overview-cuspmvp-slides.html
    February 01, 2017 - Designed to improve safety culture and help users learn from mistakes.

  15. Accessible Facilitator Guide: Designing a Scorecard (doc file)

    www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/surgery/modules/sustainability/sustainability_sustscorecard_facnotes.docx
    December 01, 2017 - was shared from the perspective of sustainability, teams were instructed to focus on learning from mistakes

  16. Designing a Scorecard for Sustainability: Facilitator Notes | Agency for Healthcare Research and Quality

    www.ahrq.gov/hai/tools/surgery/modules/sustainability/scorecard-fac-notes.html
    December 01, 2017 - was shared from the perspective of sustainability, teams were instructed to focus on learning from mistakes

  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33755/psn-pdf
    September 01, 2013 - https://psnet.ahrq.gov//#ref3 https://psnet.ahrq.gov//#ref4 https://psnet.ahrq.gov//#ref5 about one's mistakes

  18. References | Agency for Healthcare Research and Quality

    www.ahrq.gov/patient-safety/reports/hotline/refs.html
    May 01, 2016 - New system for patients to report medical mistakes. New York Times; September 23, 2012. 46.

  19. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33754/psn-pdf
    September 01, 2013 - RW: When you now see health care delivery institutions, hospitals and others, grappling with bad mistakes

  20. AHRQ Hospital Survey 2.0 User's Guide (pdf file)

    www.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/hospital/AHRQ-Hospital-Survey-2.0-Users-Guide-5.26.2021.pdf
    January 01, 2021 - Learning— Continuous Improvement Work processes are regularly reviewed, changes are made to keep mistakes … from happening again, and changes are evaluated. 3 Reporting Patient Safety Events Mistakes of … the following types are reported: (1) mistakes caught and corrected before reaching the patient and … (2) mistakes that could have harmed the patient but did not. 2 Response to Error Staff are treated … fairly when they make mistakes and there is a focus on learning from mistakes and supporting staff
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