-
www.ahrq.gov/funding/grant-mgmt/nces.html
November 01, 2020 - extension can only be considered by AHRQ if the grantee can demonstrate that unusual circumstances occurred
-
www.ahrq.gov/sites/default/files/2024-01/vanschaik-report.pdf
January 01, 2024 - On the rare occasions
that interprofessional co-facilitation occurred prior to implementation of the … When this occurred, the discussion was brief and limited to
generic statements about the importance … Discussions
about medical management were less physician focused and more frequently occurred in the … Perspective taking
was uncommon, and mostly occurred in the context of physician participants explaining … If so, why do you think they
occurred?
-
www.ahrq.gov/sites/default/files/2024-05/nishisaki-report.pdf
January 01, 2024 - Desaturation (SpO2<80%) or adverse TIAEs occurred in 5/20 (25%) of children with
high-quality breath … Desaturation (SpO2<80%) or adverse TIAEs occurred in 5/20 (25%) of children with
high-quality breath
-
www.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/teamwork/pf-engagement-fac-guide.html
July 01, 2023 - Generally, only findings that are reasonably certain to have occurred and unlikely to change should be … investigate and analyze it (e.g., a root cause analysis may be conducted) to determine whether patient harm occurred
-
www.ahrq.gov/research/publications/search.html?page=10
March 01, 2016 - experienced by hospital patients in 2011, 2012, 2013, and 2014 relative to the number of HACs that would have occurred
-
www.ahrq.gov/research/publications/search.html?page=12
February 01, 2015 - experienced by hospital patients in 2011, 2012, and 2013 relative to the number of HACs that would have occurred
-
www.ahrq.gov/patient-safety/reports/issue-briefs/state-of-science-2b.html
June 01, 2020 - events so they can review the medical record to determine if an actual or potential adverse event has occurred … Process breakdown taxonomy, 97 both of which help to identify where in the diagnostic process a problem occurred
-
www.ahrq.gov/sites/default/files/wysiwyg/topics/public-notes-meeting-summary-111921.pdf
March 11, 2022 - Workgroup Summary: The latest Workgroup meeting occurred virtually on November 19,
2021, from 1 p.m.
-
www.ahrq.gov/sites/default/files/wysiwyg/topics/diagnostic-safety-workgroup-march-2022-meeting-notes.pdf
January 01, 2022 - Workgroup Summary: The latest Workgroup meeting occurred virtually on March 11, 2022,
from 11 a.m.
-
www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-reimagining-healthcare-teams-1.html
July 01, 2023 - Some of the most significant healthcare AI/ML advancements have occurred in diagnostics.
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety-2/vol1/Advances-Faltz_56.pdf
March 27, 2008 - These errors occurred in a wide variety of locations
(Table 3).
Table 3. … Of the latter, two of the four cases occurred when the vendor
representative handed the wrong component … Presentations included a
detailed description of a recent wrong-sided surgical sentinel event that occurred … Of these, two-thirds occurred in settings other
than the operating room.
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/cusptoolkit/toolkit/contentcalls/twomorees-slides/Two-More-Es-and-How-to-Spread-Dec-13-2011-508.ppt
January 01, 2011 - Continued feedback of infection data that the team perceived as valid
Improvements in safety culture that occurred
-
www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/resources/tools/implement/action-plan.html
March 01, 2017 - has done to communicate and share survey results with staff, and an understanding of what benefits occurred
-
www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/long-term-modules/module4/guide.html
March 01, 2017 - facility leaders and administrators to share information with residents/families when an event has occurred
-
www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/availability/chipra-120-section-2-technical-specs.pdf
June 02, 2025 - CALCULATION
Step 1: Identify all deliveries that occurred in medical facilities, using the
criteria … Step 8: Count the number of high risk deliveries that occurred in Class 1 and
Class 2 facilities for
-
www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/availability/chipra-121-technicalspecs.pdf
June 02, 2025 - CALCULATION
Step 1: Identify all deliveries that occurred in medical facilities, using the
criteria … Step 8: Count the number of high risk deliveries that occurred in Class 1 and
Class 2 facilities for
-
www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/availability/chipra-0123-technical-specifications.pdf
June 02, 2025 - CALCULATION
Step 1: Identify all deliveries that occurred in medical facilities, using the
criteria …
Step 8: Count the number of high risk deliveries that occurred
-
www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/ambulatory-surgery/sections/implementation/implementation-guide/appendix-k-study-elements.docx
June 02, 2025 - Include—
· Frequency: How often the issue occurred in your study period
· Sources: Potential reasons
-
www.ahrq.gov/cahps/surveys-guidance/hospital/about/adult_hp_survey.html
January 01, 2025 - CMS implemented the HCAHPS survey in October 2006, and the first public reporting of HCAHPS results occurred
-
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 - event or issue by providing teams the
tools and resources needed to make sense of
a failure that occurred … Perinatal Care
Sensemaking &
Learn From Defects 10
miss event
We then ask why this consequence occurred … Try to view the world as
they did when the event occurred.
2. Why did it happen?
• Step 1.