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integrationacademy.ahrq.gov/playbooks/behavioral-health-and-primary-care/implementing-plan/educate-patients-and-families-about-integrated-ambulatory-care
March 01, 2024 - When patients understand the link between mind and body and the problem of fragmented care, they are … sheets: Collect psychosocial information along with medical information as part of the evaluation of any problem … Consider a “trial” of behavioral health care to reduce the impact of the patient’s underlying problem … Introduce behavioral health services as part of the practice’s normal protocol for the patient’s problem … Consider describing a patient’s problem using words that leave etiology open (e.g., distress, pain, struggle
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integrationacademy.ahrq.gov/products/playbooks/behavioral-health-and-primary-care/implementing-plan/educate-patients-and-families-about-integrated-care
January 01, 2024 - When patients understand the link between mind and body and the problem of fragmented care, they are … sheets: Collect psychosocial information along with medical information as part of the evaluation of any problem … Consider a "trial" of behavioral health care to reduce the impact of the patient's underlying problem … Introduce behavioral health services as part of the practice's normal protocol for the patient's problem … Consider describing a patient's problem using words that leave etiology open (e.g., distress, pain, struggle
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psnet.ahrq.gov/issue/patient-safety-public-health
July 19, 2023 - Medical error has been recognized as a serious problem in the United States. … July 19, 2023
The problem with the '5 whys.' … September 14, 2016
The problem with Plan-Do-Study-Act cycles.
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psnet.ahrq.gov/issue/identifying-adverse-events-reflections-imperfect-gold-standard-after-20-years-patient-safety
September 09, 2015 - The authors note that these approaches have served to demonstrate the scope of the patient safety problem … March 27, 2019
The problem with using patient complaints for improvement. … September 18, 2024
The problem with 'never events'. … August 7, 2024
Patient falls in the operating room: why is this still a problem in 2024
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psnet.ahrq.gov/issue/strategies-learning-failure
September 25, 2024 - detection and reporting of problems by frontline staff, and promote experimentation and creative problem-solving … September 25, 2024
Speaking up and taking action: psychological safety and joint problem-solving … March 8, 2017
Development of "SWARM" as a model for high reliability, rapid problem solving
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psnet.ahrq.gov/issue/applying-human-factors-engineering-address-telemetry-alarm-problem-large-medical-center
February 10, 2021 - Study
Applying human factors engineering to address the telemetry alarm problem in … Applying human factors engineering to address the telemetry alarm problem in a large medical center. … Applying human factors engineering to address the telemetry alarm problem in a large medical center. … February 10, 2021
Indication alerts to improve problem list documentation.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/ambulatory-surgery/sections/sustainability/management/problem-solving/problem-solving.pptx
May 01, 2017 - Module 3: PowerPoint Presentation
Management Practices for Sustainability
Module 3: Problem Solving … No. 16(17)-0019-4-EF
May 2017
Module 3: Problem Solving and Escalation | ‹#›
AHRQ Safety Program … Concept Example
Problem: An undesirable gap between an expected state and the actual state of a system … Practices for Sustainability
Four Problem Boxes
Module 3: Problem Solving and Escalation | ‹#› … Try the Problem Triage flowchart as your initial guide
Module 3: Problem Solving and Escalation |
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psnet.ahrq.gov/issue/risk-factors-and-outcomes-foreign-body-left-during-procedure-analysis-413-incidents-after
December 04, 2016 - This study examined the problem of retained foreign bodies in pediatric surgery, using cases identified … Despite the persistence of this problem, controversy remains around how to prevent such errors. … December 23, 2016
The recurring problem of retained swabs and instruments. … April 17, 2013
Retained surgical items: a problem yet to be solved.
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psnet.ahrq.gov/issue/she-was-headed-locked-psych-ward-then-er-doctor-made-startling-discovery
March 03, 2021 - This news story illustrates the problem of omissions due to potential stigma associated with patient … December 14, 2016
The other big drug problem: older people taking too many pills. … November 4, 2020
A doctor gave me an inept diagnosis for a neurological problem.
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psnet.ahrq.gov/issue/wicked-problem-patient-misidentification-how-could-technological-revolution-help-address
July 10, 2024 - Commentary
The wicked problem of patient misidentification: how could the technological … The wicked problem of patient misidentification: How could the technological revolution help address … The wicked problem of patient misidentification: How could the technological revolution help address
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/ambulatory-surgery/sections/sustainability/management/problem-solving/problem-solving-facnotes.docx
May 01, 2017 - SLIDE 3
Title: What Is a Problem? What Is a Solution? … [1: ]
Often, it is appropriate to apply type 2 problem solving to understand why the problem occurred … When problem solving prevents organizational learning. … This is problem solving and escalation in action. … Turning to problem solving:
· A first test—can you assign a problem to one of the four boxes and follow
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psnet.ahrq.gov/issue/other-big-drug-problem-older-people-taking-too-many-pills
December 14, 2016 - Newspaper/Magazine Article
The other big drug problem: older people taking too many … Citation Text:
The other big drug problem: older people taking too many pills. Boodman SG. … URL
Cite
Citation
Citation Text:
The other big drug problem … June 14, 2017
'America's other drug problem': copious prescriptions for hospitalized
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/ambulatory-surgery/sections/sustainability/management/problem-solving/problem-solving-component-kit.docx
May 01, 2017 - What Are Problem Solving and Escalation? 2
2. What Is a Problem and What Is a Solution? 2
3. … What Are Problem Solving and Escalation? … What Is a Problem and What Is a Solution? … Problem Triage
Imagine that a staff member identifies a problem. … Such a problem will require deeper analysis to understand the root problems and the problem may require
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psnet.ahrq.gov/issue/risk-medication-errors-hospital-discharge-and-barriers-problem-resolution
November 03, 2015 - Study
Risk of medication errors at hospital discharge and barriers to problem resolution … Citation Text:
Risk of medication errors at hospital discharge and barriers to problem resolution. … Citation
Citation Text:
Risk of medication errors at hospital discharge and barriers to problem
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psnet.ahrq.gov/issue/diagnostic-error-critically-ill-defining-problem-and-exploring-next-steps-advance-intensive
January 24, 2024 - Commentary
Diagnostic error in the critically ill: defining the problem and exploring … Diagnostic Error in the Critically III: Defining the Problem and Exploring Next Steps to Advance Intensive … Diagnostic Error in the Critically III: Defining the Problem and Exploring Next Steps to Advance Intensive
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digital.ahrq.gov/sites/default/files/docs/citation/r01hs022542-hettinger-final-report-2020.pdf
January 01, 2020 - Cognitive Engineering for Complex Decision Making & Problem Solving in Acute Care - Final Report … Cognitive Engineering for Complex Decision Making & Problem
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psnet.ahrq.gov/issue/problem-based-training-improves-recognition-patient-hazards-advanced-medical-students-during
September 11, 2024 - Study
Problem-based training improves recognition of patient hazards by advanced … Problem-based training improves recognition of patient hazards by advanced medical students during chart … Problem-based training improves recognition of patient hazards by advanced medical students during chart
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digital.ahrq.gov/sites/default/files/docs/publication/r21hs022166-beebe-final-report-2016.pdf
January 01, 2016 - The Long Term Effectiveness of Telephone Intervention Problem Solving (TIPS) - Final Report … The long term effectiveness of Telephone Intervention Problem Solving (TIPS). … adherence but persons with SSDs have limited access to problem solving
interventions. … Problem-solving therapy: A positive approach to clinical
intervention. 3rd ed. … The long term effectiveness of Telephone Intervention Problem Solving (TIPS).
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psnet.ahrq.gov/perspective/soil-not-seed-real-problem-root-cause-analysis
March 01, 2007 - The Soil, Not the Seed: The Real Problem with Root Cause Analysis
Patrice Spath, BA, RHIT, and William … The Soil, Not the Seed: The Real Problem with Root Cause Analysis. PSNet [internet]. … The Soil, Not the Seed: The Real Problem with Root Cause Analysis. PSNet [internet]. … If we are correct, then the RCA tool is not the problem. … The Soil, Not the Seed: The Real Problem with Root Cause Analysis. PSNet [internet].
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psnet.ahrq.gov/issue/applying-modern-error-theory-problem-missed-injuries-trauma
June 15, 2011 - Study
Applying modern error theory to the problem of missed injuries in trauma. … Applying modern error theory to the problem of missed injuries in trauma. … Applying modern error theory to the problem of missed injuries in trauma.