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  1. pcmh.ahrq.gov/innovations/index.html
    August 01, 2021 - topics in this section Innovations Downloadable Databases Connecting Those at Risk … Connecting Those at Risk to Care: The Quick Start Guide to Developing Community Care Coordination Pathways … Pathways Community HUB Manual: A Guide to Identify and Address Risk Factors, Reduce Costs, and Improve
  2. pcmh.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/strategies/medication/tool_safe-oxytocin.docx
    May 01, 2017 - of error.12 · The risks and benefits of low- versus. high-dose oxytocin protocols remain an active … The use of standard NICHD nomenclature17,18,19 reduces confusion and risk of error. … · Use unit-established process for conveying risks and benefits of oxytocin use to patient and family … Verifying and documenting indications for use (continued) discussion with patient of risks and benefits … and documentation of the discussion about risks, benefits, and alternatives should be documented to
  3. pcmh.ahrq.gov/cahps/quality-improvement/improvement-guide/6-strategies-for-improving/communication/strategy6i-shared-decisionmaking.html
    April 01, 2023 - These tools increase knowledge, improve risk estimates, increase patient's involvement in decisions, … benefited from an increased level of understanding that allowed discussions to focus on the critical risk … key to success lies in training physicians and other members of the care team to: Communicate about risks … expressed needs when making recommendations for care. 18 Clinical decision support tools, such as risk … can follow-up with patients to determine whether they understood that they had options, how much the risks
  4. pcmh.ahrq.gov/health-literacy/publications/ten-attributes.html
    January 01, 2024 - Addresses health literacy in high-risk situations, including care transitions and communications about … The AHRQ Academy Playbook on Integrating Behavioral Health in Primary Care Toolkit to Engage High-Risk … Addresses health literacy in high-risk situations, including care transitions and communications about … High-risk decisions, situations, and transitions demand more attention to health literacy. … Medications at Transitions and Clinical Handoffs (MATCH) Toolkit for Medication Reconciliation: High-Risk
  5. pcmh.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/lep/handouts/lepslhandouts.pdf
    July 25, 2012 - for Patients With Limited English Proficiency Overview/Objectives  Understand the safety risk … teen  $71 million lawsuit 2 TeamSTEPPS LEP Patient Safety | Essentials Essentials High-Risk … Surgery  Transitions in care, including intake and discharge  Medication reconciliation Added Risk … history  Latex allergy almost missed before surgery “Opportunity” Scenario  What are the risks
  6. pcmh.ahrq.gov/patient-safety/settings/hospital/fall-prevention/toolkit/postfall-assessment.html
    January 01, 2013 - Word Version [ - 33.64 KB] Background: This protocol explains how to assess and follow injury risk … Postfall Assessment, Clinical Review Note: There is increased risk of intracranial hemorrhage in patients … medical record, document the incident, outcome, and initial and ongoing observations, and update fall risk
  7. pcmh.ahrq.gov/patient-safety/settings/hospital/fall-prevention/toolkit/overview.html
    January 01, 2013 - Fall prevention involves managing a patient's underlying fall risk factors (e.g., problems with walking … fall prevention care are highly routinized; other aspects must be tailored to each patient's specific risk … Joint Commission standards require ongoing efforts to assess risk for falls and to intervene to reduce … fall risk; staff education regarding fall prevention; and an evaluation of the effectiveness of the … hospital's fall prevention strategies, including fall risk assessment, interventions, and education.
  8. pcmh.ahrq.gov/sites/default/files/wysiwyg/patient-safety/settings/mcc-summit/mcc-summit-arlene.pdf
    November 17, 2020 - • Common, Costly • Health equity issue • Health system ill-designed to meet the needs of those at risk … • Prevention interventions targeted at reducing the prevalence of common chronic disease risk factors … with a particular focus on interventions to reduce the likelihood those “at risk” will go on to develop … MCC • Targeted interventions to improve health and reduce the risk of adverse events and complications … issues • Targeted interventions for those who have complex management issues and who are at “high risk
  9. pcmh.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/candor/module3/mod03-gap-analysis-guide.pdf
    April 01, 2016 - Are governance/senior leaders regularly and thoroughly briefed on risks and hazards? b. … Are patient safety risks, hazards, and opportunities discussed and documented at board meetings? f. … Comments Leadership and Culture Are governance/senior leaders regularly and thoroughly briefed on risks … Are patient safety risks, hazards, and opportunities discussed and documented at board meetings? … There is strong consensus that improved communication between providers and patients about risks to
  10. pcmh.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/strategies/labor-delivery-unit/ldusafety-fac-guide.html
    July 01, 2023 - When Possible Say: The preoperative briefing reviews the plan ahead for patient care and the risksRisk assessments may include the presence of clinical conditions that increase risk of hemorrhage, or … Risk assessment can then determine the unit’s process for patients based on level of risk, for example … These include— Having situational awareness about maternal and fetal risks and status. … during transitions of care helps to assure a shared mental model of the plan of care and perceived risks
  11. pcmh.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4u_combo_pdi09-postoprespfailure-bestpractices.pdf
    May 17, 2016 - Recommended Practice: Assess risk factors • Determine which pediatric patients are at increased risk … o High-risk surgery (e.g., emergent and prolonged procedures, open vs. laparoscopic). … • Use nasogastric tubes selectively since they can increase the risk of aspiration. … Development and validation of a risk calculator predicting postoperative respiratory failure. … Postoperative pulmonary complications: an update on risk assessment and reduction.
  12. pcmh.ahrq.gov/news/blog/ahrqviews/achieve-health-equity.html
    August 01, 2021 - issues such as hypertension, obesity, and diabetes, they were significantly more vulnerable to the risks … important ground by exploring how differences in job characteristics and household composition impacted risks … In contrast, workers in office-based jobs who are able to work remotely have a significantly lower risk
  13. pcmh.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/fallprevention-training/module3/module3_tools.docx
    January 01, 2012 - 1 = Moderate risk 2 or above = High risk 3H: Morse Fall Scale for Identifying Fall Risk Factors … 25-45: Moderate risk >45: High risk ______ * Weak gait: Short steps (may shuffle), stooped but able … calculated by (risk level score) x (number of medications in that risk level category). … Fall Scale for Identifying Fall Risk Factors,” or 3G, “STRATIFY Scale for Identifying Fall Risk Factors … medication-related risk for falls.
  14. pcmh.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/pressure_ulcer_prevention/module4/putoolkit_module4_tools.docx
    January 01, 1995 - Hot water and soap may dry the skin and increase the risk for pressure ulcers. 5. … A low Braden score is associated with increased pressure ulcer risk. 44. … Hot water and soap may dry the skin and increase the risk for pressure ulcers. True 5. … A low Braden score is associated with increased pressure ulcer risk. True 44. … Does the education provided address risk assessment tools and procedures? 7.
  15. pcmh.ahrq.gov/sites/default/files/wysiwyg/patient-safety/rev-reportaddendum.pdf
    March 01, 2021 - Routinely assessing patient risk during this period is critical to facilitate tailoring appropriate … If left unaddressed, behavioral health and social needs are key risk factors for postdischarge adverse … Consider using a pharmacist for complex medication regimens or high-risk patients. … • Advise high-risk patients to let the primary care practice know if they are thinking about going … Risk stratification may help practices more efficiently allocate resources to high-risk patient groups
  16. pcmh.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/qitoolkit/combined/d4p_combo_pdi02-pressureulcer-bestpractices.pdf
    January 01, 2012 - equipment and devices.1 • Pressure ulcer rates are high in children, particularly those with high-risk … from 2.4 to 7.7 per 1,000 pediatric discharges (across all children).2-4 In subgroups at particular risk … (3.5 times the odds of children without the complication), even after adjusting for numerous other risk … documentation record for the completion of a total skin assessment and risk assessment.11,12 … Risk assessment & prevention of pressure ulcers 2011 supplement. Toronto, ON: RNAO; 2011. 11.
  17. pcmh.ahrq.gov/npsd/data/dashboard/index.html
    October 01, 2023 - Pressure Ulcer Dashboard Details the documentation of increased risk for pressure ulcer following a … risk assessment; and the timing of the first risk assessment for reported pressure ulcers or sDTIs. … new analyses by age, deeper explorations of common activities prior to fall, and enhanced analyses of risk … falls, as well as the ability to filter by fall assistance and use of medication known to increase risk
  18. pcmh.ahrq.gov/funding/grantee-profiles/grtprofile-dalal.html
    January 01, 2024 - Dalal received a 5-year AHRQ grant to create a digital health app that predicts the risk of post-discharge … noted that “clinically-integrated digital health apps have the potential to more accurately predict risk … It also will help patients to understand their individualized risks of adverse events during care transitions
  19. pcmh.ahrq.gov/patients-consumers/patient-involvement/index.html
    November 01, 2016 - Patients and families who engage with health care providers ask good questions and help reduce the risk
  20. Ldusafety Facguide (doc file)

    pcmh.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/tools/perinatal-care/modules/strategies/labor-delivery-unit/ldusafety_facguide.docx
    May 01, 2017 - Checklists help to facilitate safety in high-complexity, high-risk, and high-reliability professions … sections Slide 9 SAY: The preoperative briefing reviews the plan ahead for patient care and the risks … .18-21 · Individual risk factors predict some occurrences of obstetric hemorrhage. · Risk assessments … These include— Having situational awareness about maternal and fetal risks and status. … during transitions of care helps to assure a shared mental model of the plan of care and perceived risks

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