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www.ahrq.gov/hai/tools/ambulatory-surgery/sections/sustainability/management/overview-fac-notes.html
June 01, 2017 - Researchers have wondered about this problem. … The IHI team studied 10 leading health care organizations that have made headway in solving this problem—leaders … like daily huddles, the use of visual boards to present data at the front line, having well-understood problem … Moving to the bottom center: Problem solving methods are key for identifying and addressing problems … Without skill in problem solving methods, the huddles and visual management boards end up seeming pointless
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www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/education-bundles/urine-culturing/when-to-order/worksheet.html
May 01, 2017 - A ssessment – What did Nurse Nohai think was the problem?
… Bell does not usually have a problem getting around, but he fell three times in the past week.
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www.ahrq.gov/patient-safety/settings/long-term-care/resource/facilities/ltc/mod1sess2.html
October 01, 2014 - These kinds of changes put the resident at risk for falling and also may signal an underlying problem … Perhaps a small stroke occurred, or the resident has another new medical problem that is contributing … , and to detect a problem requiring new treatment. … If you only reported things that turned out to be a problem, you would probably have missed some. … Sometimes the nursing assistant needs to report the problem again to the licensed nurse.
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www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/implementation/long-term-modules/module2/tools.html
March 01, 2017 - In a solution that paired technical problem solving with accountability, the facility established a single … The intranet site allowed the senior leadership team members to solve a problem with a minimal amount … Clarifying decision-making, conflict management, and problem-solving processes.
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www.ahrq.gov/patient-safety/settings/hospital/resource/pressureulcer/tool/pu7b.html
October 01, 2014 - Problem:
Requires moderate to maximum assistance in moving. … Potential Problem:
Moves feebly or requires minimum assistance. … Encourage patient to report any other moisture problem (such as under breasts). … Friction and Shear
Problem
Skin assessment and inspection q shift. … Potential Problem
Keep bed linens clean, dry, and wrinkle free.
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www.ahrq.gov/es/patient-safety/settings/hospital/resource/pressureulcer/tool/pu7b.html
October 01, 2014 - Problem:
Requires moderate to maximum assistance in moving. … Potential Problem:
Moves feebly or requires minimum assistance. … Encourage patient to report any other moisture problem (such as under breasts). … Friction and Shear
Problem
Skin assessment and inspection q shift. … Potential Problem
Keep bed linens clean, dry, and wrinkle free.
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digital.ahrq.gov/ahrq-funded-projects/ambulatory-care-compact-organize-risk-and-decisionmaking-accord/annual-summary/2010
January 01, 2010 - and problem-linked comment for the structured problem list and 2) integrating ACCORD event notification … Intervention group providers will be trained to use ACCORD in both the episodic, one problem at a time … To support the care process, the ACCORD documentation should be able to drive updates to the problem … list, and place text where the plan of care for the problem usually goes. … What makes problem-linking more or less difficult is the specificity of the ACCORD template and where
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www.ahrq.gov/sites/default/files/wysiwyg/cahps/quality-improvement/improvement-guide/6-strategies-for-improving/communication/cahps-strategy-section-6-g.pdf
July 31, 2017 - The Problem
People rarely complain about the technical aspects of the health care they receive
because—in … History-taking skills
Issues related to communicating across cultures
Communicating with “problem … 6.G-3
Some programs also address
weaknesses in written
communications, which can be a
serious problem … Many individuals in this stage are unaware or
under-aware that a problem exists. … The Problem
6.G.2. The Intervention
6.G.3. Example
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www.ahrq.gov/hai/cauti-tools/ena-slides/part1a.html
October 01, 2015 - So whose problem is urinary catheterization anyway? Emergency nurses? Inpatient nurses? Providers? … Assumptions around catheter use and the issues they create become the problem of the institution, not … Slide 57
Perception -- whose problem is it?
CAUTI does not "belong" to the ED. … Slide 61
The problem with assumptions
Problematic Expectations
Because it is customary for many … Slide 62
Problem with assumptions
Assumption of a catheter in place.
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digital.ahrq.gov/sites/default/files/docs/resource/mcconnochie.pdf
January 01, 1994 - Please include the family’s phone
number and, ideally, a few words describing the problem if you text … Also, with 4 neighborhood telemedicine access sites in the city, follow-up of an
acute problem seen … Green stickers in the phone “triage” protocol books identify situations in which the
child’s problem … An ED visit for a problem that can be managed by telemedicine costs 7- to 10-fold more. … Phone nurse or physician covering calls determines the problem should be seen some time within
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www.ahrq.gov/sites/default/files/wysiwyg/pqmp/measures/chronic/chipra-240-section-5-table-2.pdf
May 01, 2010 - (p. s168) Clinicians should use
neutral terms to discuss the problem with
families, such as ‘weight … appropriate
setting for weight discussions because the
setting frames the condition as a health
problem … Solving the
problem of childhood
obesity within a generation.
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psnet.ahrq.gov/node/40390/psn-pdf
February 03, 2015 - The $17.1 billion problem: the annual cost of measurable
medical errors. … The $17.1 Billion Problem: The Annual Cost Of Measurable
Medical Errors. … https://psnet.ahrq.gov/issue/171-billion-problem-annual-cost-measurable-medical-errors
The Centers for … https://psnet.ahrq.gov/issue/171-billion-problem-annual-cost-measurable-medical-errors
https://psnet.ahrq.gov
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psnet.ahrq.gov/node/860049/psn-pdf
January 04, 2024 - medical errors and, in
one review of IT-related malpractice claims, was identified as a contributing problem … clinical information and evaluating that information
against known illness scripts, often involves problem … Harnessing the
power of problem representation can help us continue to think critically about our patients … Careful constructions of problem presentations, particularly in children with chronic medical
conditions … The importance of early problem representation during case
presentations.
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digital.ahrq.gov/technology/clinical-informatics
January 01, 2023 - Hettinger, Aaron Zachary
Project Name
Cognitive Engineering for Complex Decisionmaking & Problem … Investigator(s)
Agarwal, Ritu
Cognitive Engineering for Complex Decisionmaking & Problem … Cognitive Engineering for Complex Decisionmaking & Problem Solving in Acute Care - Final Report. … Hettinger, Aaron Zachary
Project Name
Cognitive Engineering for Complex Decisionmaking & Problem
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www.ahrq.gov/sites/default/files/wysiwyg/cahps/quality-improvement/improvement-guide/6-strategies-for-improving/communication/cahps-strategy-section-6-j.pdf
July 01, 2017 - The Problem
Patients often express dissatisfaction because they are not getting everything they need … Health plans, medical groups, and physician practices can play two important roles to
counter this problem … Such programs are based on self-efficacy theory and emphasize
problem solving, decision making, and … The Problem
6.J.2. The Intervention
6.J.3. Benefits of These Interventions
6.J.4.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/pdi/a4_pdi_casestudy.pdf
December 01, 2015 - One specific problem was that physicians were ordering temporary lines such as
peripherally inserted … cell transplant division and made it clear to everyone
why physicians needed to take ownership of the problem … Drilling down to the root causes of the problem revealed a variety of issues. … By clarifying how the existing phone-based ordering process contributed to the problem, the
improvement … presentation template so that it would support her need to educate clinicians and staff
about the problem
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psnet.ahrq.gov/node/41796/psn-pdf
January 18, 2013 - Retained surgical items: a problem yet to be solved. … Retained surgical items: a problem yet to be solved. … https://psnet.ahrq.gov/issue/retained-surgical-items-problem-yet-be-solved
Stories of retained surgical … https://psnet.ahrq.gov/issue/retained-surgical-items-problem-yet-be-solved
https://psnet.ahrq.gov/issue
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/quality-resources/tools/cauti-ltc/modules/resources/tools/implement/team-roster.docx
March 01, 2017 - Infection Preventionist
Data driven
Collaborative
Problem solver
Advocate
· Ensure data collection/ … Physician Champion
Resourceful
Problem solver
Influencer
Data driven
· Educate peers about HAIs/CAUTI … Frontline Champion
Resourceful
Problem solver
· Inspire others to commit to goals and interventions
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www.ahrq.gov/hai/cauti-tools/phys-championsgd/appa.html
October 01, 2015 - A concise statement of the problem. … R
Recommendation/Request – What action/recommendation is needed to correct the problem?
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psnet.ahrq.gov/web-mm/airway-obstruction-during-anterior-cervical-spine-surgery
January 29, 2021 - the surgeon identified faulty positioning of the surgical retractor as the most likely cause of the problem … ventilator. 8 If ventilation remains inadequate after switching to the Ambu bag, the origin of the problem … An ultrasound, chest radiograph, or flexible bronchoscopy may help to diagnose the cause of the problem … Mental stress from the “blame game” makes it more difficult to solve the problem in a timely manner. … Trying to troubleshoot the equipment problem without using a bag-valve resuscitator may lead to hypoxemia