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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/ambulatory-surgery/sections/implementation/training-tools/defects.docx
May 01, 2017 - What can we do to reduce the risk of it happening again? … Did the interventions reduce the likelihood of recurrence of the defect? Has it happened again?
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www.ahrq.gov/hai/tools/surgery/modules/sustainability/learn-from-defects-slides.html
December 01, 2017 - Missing equipment in line cart
First-order problem solving
Addresses for one patient, but does not reduce … How will you reduce the risk of it happening again?
How will you know the risk is reduced? … Slide 13: How Will You Reduce Risk of Recurrence? … Slide 14: How Will You Reduce Risk of Recurrence?
Take advantage of your diverse team . … Slide 16: How Will You Reduce Risk of Recurrence?
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www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-dx-stewardship3.html
August 01, 2024 - Introduction
Background
Diagnostic Error in the Testing Process
Diagnostic Stewardship Interventions To Reduce … Concurrent initiatives in imaging stewardship, for instance, aim to increase appropriate use of imaging and reduce
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/medicaidreadmitguide/aspire_webinar5/aspire_webinar5.pptx
June 02, 2025 - investing effort to identify Medicaid-relevant providers and agencies is core to effective efforts to reduce … readmissions
Describe a step-wise approach to creating “effective referral pathways” to reduce barriers … identify ways to efficiently connect with a care manager if one exists
Develop “referral pathways” to reduce
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/reducing-unnecessary-urinary-catheter-use-ed.pptx
June 02, 2025 - through the contract, “National Implementation of Comprehensive Unit-based Safety Program (CUSP) to Reduce
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www.ahrq.gov/pqmp/implementation-qi/toolkit/asthma/introduction.html
July 01, 2021 - to develop and implement quality measurement and improvement strategies in primary care settings to reduce … Department Use measure,
Developing and implementing quality measurement and improvement strategies to reduce
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/reducing-unnecessary-urinary-catheter-use-ed-transcript.docx
June 02, 2025 - Why is it important that efforts to reduce CAUTI include the emergency department? … are admitted to the hospital come through the emergency department, it is important that efforts to reduce
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/clabsi-cauti-icu/engaging-senior-leaders.pdf
April 01, 2022 - to help intensive care unit (ICU) team
leaders implement effective strategies and achieve goals to reduce … Senior leaders can take these actions to ensure they are supporting the team working to reduce CLABSI … Conversation Starters
To engage a senior leader in efforts to reduce CLABSI and CAUTI, gather all the … Leadership rounds to reduce health care-associated
infections. … Exploring leadership within a systems approach to
reduce health care−associated infections: A scoping
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/engagingfamilies/strategy4/Strat4_Tool_3_Physician_HO_508.pdf
January 01, 2010 - providers3
Involving the patient and family in discharge planning can
improve patient outcomes, reduce … indicator of this, the Centers for Medicare and
Medicaid Services implemented new guidelines in 2012
that reduce … To improve quality and reduce preventable readmissions,
[insert hospital name] will use the Agency for
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/mvp/modules/vae/overview-ptsoffventilator-facguide.docx
January 01, 2017 - In doing so, you will effectively reduce the risk of ventilator-associated pneumonia (VAP) and other … Interventions to improve patient outcomes and reduce complications focus on the importance of getting … Slide 11
AHRQ Safety Program Goals
SAY:
The two main safety program goals are: (1) reduce the risk … By getting patients off of the ventilator faster, you will reduce the risk of patient harms associated … Combining all six of these interventions can effectively reduce ventilator associated events, reduce
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www.ahrq.gov/hai/tools/surgery/tools/applying-cusp/learn-from-defects.html
December 01, 2017 - How will you reduce the likelihood of the defect happening again? … Create a plan to reduce the likelihood of this defect repeating. … How will you reduce the likelihood of this defect happening again? … How will you reduce the likelihood of the defect happening again? … Create a plan to reduce the likelihood of this defect repeating.
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/mrsa/011-blood-culture-webinar-slides.pptx
October 01, 2024 - associated with blood culture contamination
Discuss strategies to promote blood culture stewardship and reduce … Blood Culture Stewardship1
Blood culture (BCx) stewardship aims to optimize bacteremia detection and reduce … Effectiveness of practices to reduce blood culture contamination: a Laboratory Medicine Best Practices … Effectiveness of introducing blood culture collection packs to reduce contamination rates. … Cost analysis of strategies to reduce blood culture contamination in the emergency department: sterile
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www.ahrq.gov/nursing-home/best-practices/index.html
May 01, 2022 - and Prevention in Nursing Homes
Best Practices to Help Nursing Home Residents and Their Families to Reduce … Best Practices to Help Nursing Home Residents and Their Families to Reduce the Impact of Social Isolation
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www.ahrq.gov/patient-safety/settings/hospital/resource/about.html
December 01, 2017 - recommendations, and other resources for hospitals and hospital administrators to improve quality, reduce … Healthcare Research and Quality commissioned this guide to identify ways evidence-based strategies to reduce … Universal ICU Decolonization Protocol
The REDUCE MRSA Trial (Randomized Evaluation of Decolonization … Methicillin-Resistant Staphylococcus aureus) found that universal decolonization was the most effective intervention to reduce
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www.ahrq.gov/sites/default/files/wysiwyg/antibiotic-use/long-term-care/changing-system-slides.pptx
June 01, 2021 - Develop an intervention to reduce barriers and evaluate if the intervention is effective.
2
Changing … What could you do to reduce the risk?
How do you know that risk was reduced? … contributing
factors limited the impact
of harm
14
Changing the System
14
What Could You Do To Reduce … Checklists/cognitive aid Architectural/physical design changes
Warnings and labels Increased staffing/reduce
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www.ahrq.gov/sites/default/files/wysiwyg/action-alliance/workforce-turnover-crisis.pdf
April 01, 2025 - Session 1: Leadership Strategies that Improve
Workforce Safety and Well-being
• To improve safety and reduce … loop/provide feedback about actions taken
► Ask about what is going well (psychological safety)
• To reduce … Session 2: Addressing Healthcare
Workforce Burnout
• Reduce depersonalization & increase meaning from … •What specific strategies can healthcare leaders implement to
reduce staff turnover? … JAMA Health Forum
Interventions that Physicians and
Nurses Ranked as
“Very Important” to Reduce
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www.ahrq.gov/sites/default/files/wysiwyg/evidencenow/building-capacity/EvidenceNOW-BSC-AL-profile.pdf
September 01, 2021 - initiative of the Agency for Healthcare
Research and Quality (AHRQ) to improve heart health and help reduce … coordinate cardiovascular risk reduction efforts across the state to create efficiency,
synergy and reduce … leverage ongoing efforts
across multiple organizations, individual projects, and existing partnerships to reduce
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www.ahrq.gov/hai/universal-icu-decolonization/universal-icu-ape.html
September 01, 2013 - Decolonization, and it has been proven in research studies to protect ICU patients from infection and reduce … The REDUCE MRSA trial showed that universal decolonization is more effective than either screening and … In addition, by removing bacteria, decolonization has been shown to reduce 37 percent of clinical MRSA … A formal cost-effectiveness analysis is being conducted for the REDUCE MRSA trial. … We routinely use an antibiotic ointment in the nose to keep bacteria away to reduce the risk of infection
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www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-dx-stewardship2.html
August 01, 2024 - Introduction
Background
Diagnostic Error in the Testing Process
Diagnostic Stewardship Interventions To Reduce … bringing the clinical laboratory into a broader strategy to advance accurate and timely diagnoses and reduce
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www.ahrq.gov/sites/default/files/2024-01/smith-report.pdf
January 01, 2024 - of clinicians and
educated urology practitioners about the latest research and practices that can reduce … Using this calculation has the potential to
reduce the number of opioids prescribed by 40 percent.11 … postoperative pain to some degree and reduce the need for additional
medical pain interventions. … If now is a bad time for personal reasons, we can
reduce it by 25 percent.” … The goal of the
project is to reduce high-risk prescribing by at least five percent statewide.