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81. Tips and Suggestions for Enhancing Organizational Readiness | Agency for Healthcare Research and Quality
    www.innovations.ahrq.gov/teamstepps/readiness/abouttips.html
    April 01, 2016 - Skip to main content An official website of the Department of Health and Human Services Careers Contact Us Español FAQs Search all AHRQ sites Search small Search Menu …

82. Federal Interagency Workgroup on Improving Diagnostic Safety--March Meeting Summary (pdf file)
    www.innovations.ahrq.gov/sites/default/files/wysiwyg/topics/DxSafety-March2019-MeetingNotes.pdf
    March 08, 2019 - Federal Interagency Workgroup on Improving Diagnostic Safety--March Meeting Summary Federal Interagency Workgroup on Improving Diagnostic Safety and Quality in Health Care March Meeting Summary Workgroup Goal: Established in response to Senate Report 115-150. The Senate Committee on Appropriations requested t…

83. It Takes a Team: Preventing Infections in Ambulatory Surgery Centers (pdf file)
    www.innovations.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/ambulatory-surgery/sections/implementation/implementation-guide/appendix-l.pdf
    May 01, 2017 - Surgical site infections are infections that can occur after surgery in the part of the body where

84. AHRQ Safety Program for Perinatal Care: Monitoring for Perinatal Safety: Under the Science of Safety
    www.innovations.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/teamwork/understand/understand-science-safety.pptx
    May 01, 2017 - AHRQ Safety Program for Perinatal Care: Monitoring for Perinatal Safety: Under the Science of Safety AHRQ Safety Program for Perinatal Care Understand the Science of Safety for Perinatal Safety AHRQ Publication No. 17-0003-4-EF May 2017 1 Learning Objectives 2 AHRQ Safety Program for Perinatal Care Science of S…

85. Strategies for Improving CAHPS Clinician & Group (CG-CAHPS) Survey Scores (pdf file)
    www.innovations.ahrq.gov/sites/default/files/wysiwyg/cahps/news-and-events/events/20160315/debra-rosen-slides.pdf
    March 15, 2016 - agencies)  Focus priorities at the site or organizational level  Significant change/efforts must occur

86. USER GUIDE: Hand Hygiene Observational Audit Data Tracking Tool for Use in Skilled Nursing Facilities (pdf file)
    www.innovations.ahrq.gov/sites/default/files/wysiwyg/nursing-home/materials/hand-hygiene-audit-tool-userguide.pdf
    April 01, 2021 - USER GUIDE: Hand Hygiene Observational Audit Data Tracking Tool for Use in Skilled Nursing Facilities USER GUIDE: Hand Hygiene Observational Audit Data Tracking Tool for Use in Skilled Nursing Facilities Introduction This user guide provides step-by-step instructions for nursing home staff to use the Hand Hygien…

87. Prioritization Worksheet (pdf file)
    www.innovations.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/pdi/c1_pdi_prioritizationworksheetinstructions.pdf
    June 05, 2016 - Ideally, if your data permit, consider only costs that occur after the adverse event occurred.

88. Prioritization Worksheet (pdf file)
    www.innovations.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/c1_combo_prioritizationworksheetinstructions.pdf
    June 05, 2016 - Ideally, if your data permit, you would consider only costs that occur after the adverse event occurred

89. Introduction Instructor Guide – PDF (pdf file)
    www.innovations.ahrq.gov/sites/default/files/wysiwyg/teamstepps/longtermcare/module1/ts2-0ltc_module1_ig_intro.pdf
    January 01, 2007 - • Describe the TeamSTEPPS Master Trainer course; • Describe the impact of errors and why they occur … Introduction BARRIERS TO TEAM PERFORMANCE Slide SAY: Errors can occur … , your team will be safer, allowing the team to more readily identify and correct errors, if they occur … • Describe the TeamSTEPPS Master Trainer course; • Describe the impact of errors and why they occur … ; • Describe the impact of errors and why they occur; • Describe the TeamSTEPPS framework; and

90. TeamSTEPPS for Office-Based Care: Leading Teams | Agency for Healthcare Research and Quality
    www.innovations.ahrq.gov/teamstepps/officebasedcare/module4/office_lead-ig.html
    September 01, 2015 - Followup questions: When and where does planning occur for you now? Who attends? … Sample some responses, and then emphasize that updates should occur as often as necessary, particularly

91. TeamSTEPPS Primary Care Participant Handout: Video Reflections (pdf file)
    www.innovations.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/officebasedcare/handouts/video.pdf
    December 03, 2015 - TeamSTEPPS Primary Care Participant Handout: Video Reflections 6 I VIDEO REFLECTIONS pjrecrj005 As you view the video, make a note of your thoughts and observations. What problems do you see occurring? Where do you see breakdowns i:n the process of providing quaHty patient care? How coukl the breakdowns have …

92. Federal Interagency Workgroup on Improving Diagnostic Safety and Quality in Healthcare July 2020 Meeting Summary (pdf file)
    www.innovations.ahrq.gov/sites/default/files/wysiwyg/topics/public-notes-meeting-summary-072320.pdf
    November 06, 2020 - Taxonomy of diagnostic errors that could occur in the COVID-19 era, including false negatives and other

93. Distributed Cognition and the Role of Nurses in Diagnostic Safety in the Emergency Department (pdf file)
    www.innovations.ahrq.gov/sites/default/files/wysiwyg/patient-safety/reports/issue-briefs/distributed-cognition-er-nurses.pdf
    August 01, 2022 - 0026-2-EF. 1 e Introduction Each year, approximately 141 million emergency department (ED) visits occur … Thus, distributed cognition will not occur. … diagnostic process and a patient’s journey through the ED and may help prevent the anchoring bias that can occur … documented but solutions to the problem are sparse.44-46 For example, communication breakdowns can occur … Thus, it is no wonder that diagnostic errors occur.

94. Transitional Care Medication Safety: Stakeholders' Perspectives | Agency for Healthcare Research and Quality
    www.innovations.ahrq.gov/patient-safety/reports/liability/corbett.html
    August 01, 2017 - experience at least one medication discrepancy in the transition from hospital to home, and discrepancies occur … for all classes of medicines. 9-11 Medication discrepancies that occur during the transition from hospital … institution confirms the transfer and assumption of responsibility, 15 assigning liability for errors that occur … sub-theme of our focus group findings regarding patient harm and liability was that full disclosure should occur … When errors that result in harm occur, full disclosure is the best practice.

95. Module 3: Problem Solving and Escalation - Facilitator Notes | Agency for Healthcare Research and Quality
    www.innovations.ahrq.gov/hai/tools/ambulatory-surgery/sections/sustainability/management/problem-solving-fac-notes.html
    June 01, 2017 - She will know that it is successful when fewer similar problems occur. … remind you that there are resources to facilitate escalation of critical, safety-related issues that may occur

96. AHRQ Quality and Safety Review System (QSRS) | Agency for Healthcare Research and Quality
    www.innovations.ahrq.gov/cpi/about/otherwebsites/qsrs.ahrq.gov/index.html
    March 01, 2021 - Skip to main content An official website of the Department of Health and Human Services Careers Contact Us Español FAQs Search all AHRQ sites Search small Search Menu …

97. TeamSTEPPS Fundamentals Course: Module 6. Mutual Support | Agency for Healthcare Research and Quality
    www.innovations.ahrq.gov/teamstepps/instructor/fundamentals/module6/igmutualsupp.html
    March 01, 2019 - which information must be communicated, a leader must be clearly designated, and mutual support must occur … Return to Contents Conflict in Teams Say: Conflict can occur in teams and it is important to … know how to handle such situations when they occur. … Can we agree to follow such a procedure if this were to occur again?"

98. Improving-Facnotes (doc file)
    www.innovations.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/ambulatory-surgery/sections/implementation/training-tools/improving/improving-facnotes.docx
    May 01, 2017 - It is important to identify and recognize the structure of teams, because teamwork cannot occur in the … Healthcare Research and Quality’s or AHRQ’s TeamSTEPPS program depicts some of the interactions that occur … physician is often not present until the procedure is about to begin, this means the briefing should occur … the surgical team waits to have the debriefing, the greater the likelihood the debriefing will not occur … Slide 43 SAY: Studies show that many times when adverse events occur in the surgical environment,

99. TeamSTEPPS Fundamentals Course: Module 3. Communication | Agency for Healthcare Research and Quality
    www.innovations.ahrq.gov/teamstepps/instructor/fundamentals/module3/igcommunication.html
    March 01, 2019 - which information must be communicated, a leader must be clearly designated, and mutual support must occur … Discuss findings with the group regarding root cause analyses from events that occur in your organization … Shift change—Transitions in care are the most significant time when communication breakdowns occur. … Discussion: Where might miscommunication occur in this situation?

100. TeamSTEPPS® Teamwork Perceptions Questionnaire Manual (pdf file)
     www.innovations.ahrq.gov/sites/default/files/wysiwyg/teamstepps/instructor/reference/teamperceptionsmanual.pdf
     June 01, 2010 - al. argued that such a conceptualization provides a more precise understanding of how learning can occur … Researchers have noted that changes in scores on a given measure can occur on multiple planes (Golembiewski … Change can occur as a function of varying levels of performance on a given set of criteria, such as … However, change can also occur as the result of a shift in how participants perceive a construct to