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www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/medicaidmgmt/tap2.html
October 01, 2014 - Program Implementation
Clients are identified and enrolled in the care management program in the following … Patient self-management. … Offering Chronic Care Patient Registry Reports to providers. … Chronic Care Patient Registry Report
The Chronic Care Patient Registry Report, distributed by the vendor … Virginia now has actively engaged MR/DD waiver clients and has received no complaints.
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www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/medicaidmgmt/mm1.html
October 01, 2014 - √ Support of providers and patients. … The PCCM program established a medical home for patients. … Identify interventions needed for patients.
Refer patients into program. … How Can We Engage the Patient Community? … By securing the patient and patient advocacy community's support, States have received useful input on
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effectivehealthcare.ahrq.gov/sites/default/files/04_dementia_potential_high_impact_june_2012.pdf
January 01, 2012 - On the other
hand, some thought that knowing that a patient has AD could aid planning in terms of safety … and care of the patient … and care of the patient. … A diagnosis could, however, aid patients and families in planning for the patient’s care and safety. … AD
patients.
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www.ahrq.gov/research/findings/factsheets/children/new-starts/2011.html
October 01, 2014 -
Introduction
The mission of the Agency for Healthcare Research and Quality is to improve the safety … safety across pediatric care settings. … Implementation of Electronic Medical Records for Documentation: Implications for Efficiency and Safety … and quality of care provided to hospitalized patients. … The Forum produces the annual report America's Children: Key National Indicators of Well-Being , available
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/tiered-approach-notes.docx
April 01, 2022 - The model in the slide shows the integration of adaptive and technical work to improve patient care. … Then, ensure all patients receive evidence-based care through engaging, educating, executing, and evaluating … The benefit of this program is that it is designed to improve care for patients who have indwelling urinary … CUSP combines improvements in teamwork, communication, and patient safety culture together with evidence-based … The Guide to Patient Safety, is a tool that can help your CUSP team identify your unit’s barriers to
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psnet.ahrq.gov/web-mm/lethal-vertigo
September 20, 2011 - When patients experience vertigo for the first time, especially if associated with nausea and vomiting … A small percentage of patients with vertigo will require admission to the hospital to treat dehydration … ENG in the emergency room: subtest results in acutely dizzy patients. … Safety Innovations
Remote Response Team and Customized Alert Settings Help Improve … 31, 2023
Annual Perspective
Improving Diagnostic Safety
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psnet.ahrq.gov/node/866841/psn-pdf
September 23, 2024 - unfavorable social determinants of health (SDOH) can lead to poor health
outcomes.1 With access to patient-level … robust component within its electronic health record based on validated questionnaires
that collect patient-level … for financial resource strain
(18%), it was the top domain for which screening indicated patient needs … such as domestic violence and home repairs.3
Planning and Development
The keys to success of any patient … safety innovation or intervention include leadership and staff buy-in,
staff involvement in planning
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psnet.ahrq.gov/node/74253/psn-pdf
January 12, 2022 - Patient Safety Events and the Role of Patient Safety
Organizations During the COVID-19 Pandemic
January … Patient Safety Events and the Role of Patient Safety Organizations
During the COVID-19 Pandemic. … https://psnet.ahrq.gov/perspective/patient-safety-events-and-role-patient-safety-organizations-during-covid … voluntarily submitted by federally listed Patient Safety Organizations (PSOs) to the Patient Safety … Patient Safety. 2020;2(2):16-27.
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psnet.ahrq.gov/perspective/conversation-sharon-k-inouye-md-mph
December 01, 2012 - RW : Let's turn to delirium as a patient safety issue. … It seems to me it's entered the patient safety world over the last 3 or 4 years. … And that is not necessarily practical for these large-scale patient safety initiatives. … Now that it is on the patient safety radar screen, one would want to take advantage of that light and … passed safety criteria; (iii) Sedatives were not restarted for patients that passed the SAT and no longer
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www.ahrq.gov/practiceimprovement/systemdesign/leancasestudies/lean-case1.html
November 01, 2014 - Data include clinical process and outcomes data, patient safety data, patient satisfaction data, and … safety. … and outcomes assessments, and patient safety. … Patient Safety
Process changes sometimes, but not always, improved patient safety. … The use of technology meant integrated and improved patient safety processes.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/strategies/labor-delivery-unit/ldusafety.pptx
May 01, 2017 - Safety
36
References
Agency for Healthcare Quality and Research’s Patient Safety Network. … Physician-Patient Alliance for Health & Safety. 5 Benefits of Adopting Patient Safety Checklists. 2013 … Patient safety checklist No. 6: documenting shoulder dystocia. … PMID: 16648399.
42
AHRQ Safety Program for Perinatal Care
L&D Unit Safety
References
ACOG Patient Safety … Patient Safety Checklist No. 10: postpartum hemorrhage from vaginal delivery.
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effectivehealthcare.ahrq.gov/sites/default/files/pdf/prioritization-selection-of-harms.pdf
February 01, 2018 - The workgroup suggests that EPC reviews focus on indicators of more
severe harms (e.g., “serious” adverse … 9) How should input from technical and clinical experts and patients or patient advocacy groups be
used … How should input from technical and clinical experts and patients or patient advocacy groups be
used … Had to report data from
groups of in which at least
85% of the patients were
from one of the patient … What are the
harms of therapeutic interventions
for patients with ME/CFS and how
do they vary by patient
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digital.ahrq.gov/ahrq-funded-projects/rural-trial-clinic-order-entry-decision-support
January 01, 2023 - Type of Care
Preventive Care
Primary Care
Health Care Theme
Medication Safety … The system allows common access to records across providers who share patients while maintaining strict … testing in diabetics, laboratory monitoring during medication therapy, printing of medication-specific patient … Both arms received patient self-care education materials. … monitoring of hemoglobin A1c in diabetics, incidence of outpatient adverse drug events, and proportion of patients
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www.ahrq.gov/professionals/quality-patient-safety/patientsafetyculture/medical-office/2014/mosurv14chap6.html
June 01, 2014 - Medical Office Survey on Patient Safety Culture
Chapter 6. … safety and quality issues, information exchange with other settings, and ratings on quality and patient … As you will notice from the database results, there are some patient safety composites that even the … Medical offices that only specialized in Pediatrics had the highest Overall Rating on Patient Safety … Hospital or health system owned medical offices had the highest Overall Rating on Patient Safety (those
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psnet.ahrq.gov/node/33719/psn-pdf
October 01, 2011 - Most health personnel untrained in patient safety theories often
assume avoidable patient injuries are … thinking related to
patient safety.(10) The aspects of context first to be studied are those that are … culture, there have been fewer studies of the contribution of the social context to patient safety, … Human factors engineering and patient safety. Qual Saf Health Care. 2002;11:352-354. … How does context affect interventions to improve patient
safety?
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www.ahrq.gov/patient-safety/settings/long-term-care/resource/hcbs/medicaidmgmt/mm3.html
October 01, 2014 - that the primary and secondary reasons for both hospital admissions and emergency room (ER) visits for patients … Managing Comorbidities
Traditionally, States have selected patients based on primary diagnosis. … Within this category, some programs exclude certain groups, such as patients with cancer or in long-term … Many of these programs provide interventions to help patients self-manage their disease and, thus, curb … provider profiling of assigned enrollees' ER utilization to show PCCM primary care providers their patients
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psnet.ahrq.gov/sites/default/files/2023-01/spotlight_overdose_of_gabapentin_and_oxycodone_in_a_patient_with_end-stage_renal_disease.pdf
January 01, 2023 - Opioids in Renal Dysfunction13
Safety in Renal
Dysfunction
Opioid Starting Dose
(opioid naïve patients … pain, with monitoring of renal
function.23
26
APPROACH TO IMPROVING PATIENT
SAFETY
27
Approach … to Improving Patient Safety (1)
• Computerized clinical decision support (CDS) provides timely patient … leading to inappropriate alerts or failure to alert.
30
Approach to Improving Patient Safety (4) … Safety (5)
• To reduce alert fatigue and provider dissatisfaction with the EHR, many
institutions
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psnet.ahrq.gov/issue/diagnostic-errors-uncommon-conditions-systematic-review-case-reports-diagnostic-errors
June 19, 2024 - November 9, 2022
Effect of contextual factors on the prevalence of diagnostic errors among patients … March 28, 2018
Culture of safety: impact on improvement in infection prevention process
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/leveraging-cultural-change-080814.pptx
January 01, 2013 - safety concepts
Evaluate effectiveness of patient safety interventions over time
Conduct internal and … Supervisor/manager expectations and actions promoting patient safety
Organizational learning-continuous … Hospital management support for patient safety
Teamwork across hospital units (i.e. … Each person thinks they no best about the patient.
22
Scenario #2
Hospital management Support for Patient … What is the common interest here- patient safety?
What about the nurse manager?
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digital.ahrq.gov/ahrq-funded-projects/feedback-treatment-intensification-data-reduce-cardiovascular-disease-risk/annual-summary/2010
January 01, 2010 - Organization
Kaiser Foundation Research Institute
Funding Mechanism
RFA: HS07-002: Ambulatory Safety … At intervention facilities, patient-level information was obtained from the EMR on the need for treatment … proportions in control for each risk factor; treatment intensification and risk-factor improvements in patient … subgroups defined by prior adherence to prescribed medications; efficiency of the intervention in terms of patient … impact of the intervention, compared to current population management practice, on total numbers of patient