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Total Results: 1,785 records

Showing results for "problems".

301. Diagnostic Errors | PSNet
     psnet.ahrq.gov/perspective/diagnostic-errors
     December 01, 2013 - individual diagnostic acumen and the psychology of cognition may not attract those interested in system problems … In contrast to the reviewers, clinicians commonly identified organizational problems such as poor policies … Naturally, one might expect clinicians to preferentially attribute diagnostic errors to system problems … diagnostic safety: using electronic health records and system-wide workflows to intercept diagnostic problems … While I would say for junior researchers it's good to be focused, the types of problems that we're trying

302. In Conversation With… Mark Graban, MS, MBA | PSNet
     psnet.ahrq.gov/perspective/conversation-mark-graban-ms-mba
     January 01, 2015 - Everybody can point out problems. … Deming, he would say, and the number changed over time, roughly 94% of problems are due to the system … Look at what's going on in General Motors in response to ignition switch problems that have led to deaths … There's a progression where an organization should be able to find the right problems to solve early … Deming's teachings that if slogans and posters worked, we would have already solved these problems in

303. Innovation and Lean Thinking: Mutually Supportive Partners in the Transformation of Health Care | PSNet
     psnet.ahrq.gov/perspective/innovation-and-lean-thinking-mutually-supportive-partners-transformation-health-care
     January 01, 2015 - Everybody can point out problems. … Deming, he would say, and the number changed over time, roughly 94% of problems are due to the system … Look at what's going on in General Motors in response to ignition switch problems that have led to deaths … There's a progression where an organization should be able to find the right problems to solve early … Deming's teachings that if slogans and posters worked, we would have already solved these problems in

304. Addressing the quality and safety gap—parts I-III. | PSNet
     psnet.ahrq.gov/issue/addressing-quality-and-safety-gap-parts-i-iii
     January 17, 2024 - June 25, 2008 Poll: Many Sick Americans Experience Significant Financial Problems and

305. Engaging Patients in Improving Ambulatory Care. | PSNet
     psnet.ahrq.gov/issue/engaging-patients-improving-ambulatory-care
     January 17, 2024 - July 8, 2013 Poll: Many Sick Americans Experience Significant Financial Problems and

306. Human Factors Engineering | PSNet
     psnet.ahrq.gov/primer/human-factors-engineering
     December 15, 2024 - test new systems and equipment under real-world conditions as much as possible to identify potential problems … examples, it is generally agreed that human factors principles are underutilized in examination of safety problems

307. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/34094/psn-pdf
     September 27, 2017 - They analyzed more than 7000 identified problems and discovered that very few events were captured by

308. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/35716/psn-pdf
     July 10, 2008 - very few instances of patient harm, investigators noted that older patients with multiple medical problems

309. Health Care–Acquired Urinary Tract Infection: The Problem and Solutions | PSNet
     psnet.ahrq.gov/perspective/health-care-acquired-urinary-tract-infection-problem-and-solutions
     November 01, 2008 - infections—genitourinary trauma, urethral strictures, and patient immobility and discomfort are all potential problems … (Unfortunately, an external device isn't really available for women because of logistical problems.) … This type of policy intervention may also have problems of its own that need to be carefully monitored … For many patient safety problems, that type of applied epidemiological approach is appropriate: falls … On the other hand are other patient safety problems that are much more rare and get a lot more attention

310. Root Cause Analysis | PSNet
     psnet.ahrq.gov/primer/root-cause-analysis
     March 30, 2022 - A central tenet of RCA is to identify underlying problems that increase the likelihood of errors while … errors occurring at the interface between humans and a complex system) and latent errors (the hidden problems

311. An Incomplete Anesthesia History Leads to Adverse Outcomes | PSNet
     psnet.ahrq.gov/web-mm/incomplete-anesthesia-history-leads-adverse-outcomes
     January 29, 2021 - Use online registers for anesthetic problems Some health care systems offer online anesthetic problem … registers to help prevent potentially recurring anesthesia-related problems. 18 These online registers … An online register for anesthesia problems can be helpful—especially when the patient changes health … regionally organized system for facilitated reporting of potentially recurring anaesthetic-related problems

312. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/42669/psn-pdf
     September 27, 2017 - who reported pressure ulcers, medication errors, hospital-acquired infections, and intravenous line problems

313. Which End Is Which? | PSNet
     psnet.ahrq.gov/web-mm/which-end-which
     February 09, 2011 - can be so deceiving (even in open surgery), it is worth identifying the steps in the procedure where problems … recommended to place a suture on the proximal or distal end of the colon to act as a landmark and thus avoid problems … surgeon needs to keep in mind the possibility of errors such as occurred in this case when assessing problems

314. Long-term Care and Patient Safety | PSNet
     psnet.ahrq.gov/primer/long-term-care-and-patient-safety
     February 24, 2022 - Subsequent OIG reports have also found many patient safety problems and adverse events including well … documented problems, such as medication errors , health care–associated infections , and overuse … Current Context Improving safety in long-term care facilities requires research into the safety problems

315. Root Cause Analysis Gone Wrong | PSNet
     psnet.ahrq.gov/web-mm/root-cause-analysis-gone-wrong
     August 28, 2024 - Striking problems in this case include compromises of objectivity, deference to hierarchy, and lack of … These problems happen in part because in health care, in contrast with industries such as aviation, those … Some problems identified through root cause analysis cannot be solved by individual organizations but

316. Interdisciplinary teamwork | PSNet
     psnet.ahrq.gov/curated-library/interdisciplinary-teamwork
     April 17, 2025 - patient safety over the past decade, most health care organizations still experience persistent safety problems … patient safety over the past decade, most health care organizations still experience persistent safety problems … These include transparency in disclosing errors and quality problems, integration of care across teams

317. The Safety and Quality of Long Term Care | PSNet
     psnet.ahrq.gov/web-mm/safety-and-quality-long-term-care
     January 01, 2016 - As potential problems are identified, each resident's plan of care can be modified and immediately communicated … resident's condition upon return from her initial hospitalization might have prevented the cascade of problems … As potential problems are identified, processes can be reviewed to establish where change needs to occur … As problems often relate to resident management issues as well as environmental issues, diverse team

318. Abortion bans have consequences for wanted pregnancies, too. | PSNet
     psnet.ahrq.gov/issue/abortion-bans-have-consequences-wanted-pregnancies-too
     August 16, 2023 - April 1, 2020 Poll: Many Sick Americans Experience Significant Financial Problems and

319. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/37437/psn-pdf
     June 03, 2010 - As noted in a prior commentary, most published studies had significant methodologic problems that limited

320. FDA 101: How to Use the Consumer Complaint System and MedWatch. | PSNet
     psnet.ahrq.gov/issue/fda-101-how-use-consumer-complaint-system-and-medwatch
     February 15, 2024 - May 21, 2014 Safety Problems With Your Child's Medical Device?