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cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/candor/module8/module8-organizational-learning-sustainability.pptx
August 20, 2015 - Creates a culture of inquiry and dialogue in which people feel safe to share openly and take risks. … and creates a culture of inquiry and dialogue in which people feel safe to share openly and to take risks … Engage senior leaders and risk managers.
Ensure buy-in from frontline staff. … It must include engagement of key stakeholders, such as senior leaders, risk managers, staff, patients
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cahps.ahrq.gov/policymakers/hrqa99b.html
October 01, 2014 - Opportunity Guidance
AHRQ Grants Policy Notices
AHRQ Informed Consent & Authorization Toolkit for Minimal Risk … devices; (II) ways to improve the effective use of drugs, biological products, and devices; and (III) risks … of new uses and risks of combinations of drugs and biological products.
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cahps.ahrq.gov/news/newsletters/e-newsletter/899.html
February 01, 2024 - Home
News
Newsletter
AHRQ News Now
Heart Failure Patients’ Risk … Newsletter
AHRQ News Now
Events
Heart Failure Patients’ Risk … Heart Failure Patients’ Risk of Adverse Events Higher in Poor-Performing Hospitals
Patients with heart … hospitals with higher 30-day readmission rates and deaths from all causes have a 24 percent higher risk … failure admitted to hospitals that perform poorly on mortality and readmission measures have higher risk
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cahps.ahrq.gov/news/newsletters/e-newsletter/886.html
October 01, 2023 - Opportunity Guidance
AHRQ Grants Policy Notices
AHRQ Informed Consent & Authorization Toolkit for Minimal Risk … highlights that strikingly similar falls interventions are used for patients with different demographics or risks … Adverse drug events caused by three high-risk drug-drug interactions in patients admitted to intensive
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cahps.ahrq.gov/sites/default/files/wysiwyg/npsd/npsd-portfolios-summary-profile-2014.pdf
January 01, 2014 - The term safety refers to reducing
risk from harm and injury, whereas the term quality
suggests striving … PSOs aim to help providers detect and reduce risks and
hazards associated with their delivery of care … reporting, such as
sharing examples of how the event reports led to changes
that reduced health care risks
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cahps.ahrq.gov/teamstepps/lep/traintrainers/lepslstafftrain.html
July 01, 2018 - English Proficiency Slide 2: Overview/Objectives Slide 3: The Story of Willie Ramirez Slide 4: High-Risk … Settings and Situations Slide 5: Added Risk for LEP Patients Slide 6: LEP Patients in Your Clinical … Return to Contents
Slide 4: High-Risk Settings and Situations
ED.
OB/GYN.
Surgery. … Return to Contents
Slide 5: Added Risk for LEP Patients
Not using a professional interpreter: … Return to Contents
Slide 8: "Opportunity" Scenario
What are the risks in this scenario?
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cahps.ahrq.gov/funding/process/study-section/peerrev.html
March 01, 2024 - Opportunity Guidance
AHRQ Grants Policy Notices
AHRQ Informed Consent & Authorization Toolkit for Minimal Risk … It reviews applications relating to identifying risks and hazards that lead to medical errors and identifying
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cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/shareddecisionmaking/tools/tool-7/share-tool7.pdf
April 01, 2014 - aids, treatment summaries, and educational materials that have
culturally relevant descriptions of risks
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cahps.ahrq.gov/news/newsletters/e-newsletter/857.html
March 01, 2023 - News
Newsletter
AHRQ News Now
Large-Scale Program To Reduce Heart Disease Risk … AHRQ News Now
Events
Large-Scale Program To Reduce Heart Disease Risk … Poorly Coordinated Healthcare Increases Infection Risk Following Ventricular Device Implantation, Study … Health and Nutrition Examination Survey and 10-year atherosclerotic cardiovascular disease (ASCVD) risk … Poorly Coordinated Healthcare Increases Infection Risk Following Ventricular Device Implantation, Study
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cahps.ahrq.gov/news/newsletters/e-newsletter/873.html
July 01, 2023 - Opportunity Guidance
AHRQ Grants Policy Notices
AHRQ Informed Consent & Authorization Toolkit for Minimal Risk … The new brief provides basic definitions on behavioral health apps and the benefits and risks of recommending
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cahps.ahrq.gov/news/newsletters/e-newsletter/781.html
September 01, 2021 - Opportunity Guidance
AHRQ Grants Policy Notices
AHRQ Informed Consent & Authorization Toolkit for Minimal Risk … distractions, poor visibility, complicated technology interfaces and lost time that could increase a risk … of error, hinder provider performance and lead to patient safety risks.
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cahps.ahrq.gov/teamstepps/instructor/essentials/implguide3.html
November 01, 2018 - Risk Reduction Strategies (Corrective Actions):
A detailed (step-by-step) risk reduction strategy … An explanation for each root cause determined to NOT warrant risk reduction intervention. … of person(s) responsible for each step of the risk reduction strategy. … for each step of the risk reduction strategy.
… Benefits outweigh risks.
Evidence-based.
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cahps.ahrq.gov/evidencenow/projects/heart-health/evidence/cholesterol.html
March 01, 2021 - factor and an increased risk of a CVD event (>=10% in 10 years). … The USPSTF recommended discussing statin use in similar patients with more moderate risk of a CVD event … All patients at high risk should receive a high- or moderate-intensity statin unless contraindicated … factors with a calculated 10-year CVD event risk of 7.5 percent or greater.
2013 ACC/AHA Guideline … on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults
This
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cahps.ahrq.gov/news/newsletters/e-newsletter/820.html
June 01, 2022 - Opportunity Guidance
AHRQ Grants Policy Notices
AHRQ Informed Consent & Authorization Toolkit for Minimal Risk … False-Positive Cervical Cancer Result
Patients vaccinated against human papillomavirus have an increased risk … The findings suggest that the increased risk of a false-positive result for vaccinated individuals may … warrant screening guidelines that stratify by vaccination status to minimize the risks of overscreening … and overtreatment among those with low risk for cervical cancer.
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cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/systems/hospital/fallprevention-training/module3/module3_slides_best-practices.pptx
June 16, 2017 - Fall Risk Assessment
‹#›
Step 1: Fall Risk Screening/Assessment
Use a reliable, prospectively … Other risks
IV pole
Orthostatic hypotension
Oxygen tubing
Clutter in the patient’s room
Vision problems … 25-45: Moderate risk
>45: High risk ______
* Weak gait: Short steps (may shuffle), stooped but able … 25-45: Moderate risk
>45: High risk 50
‹#›
Assessment of Risk Factors in Your Hospital
The questions … Identify key elements of a fall risk factor assessment.
Choose a tool for assessing risk factors.
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cahps.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/teamwork/assemble-slides.html
July 01, 2023 - Opportunity Guidance
AHRQ Grants Policy Notices
AHRQ Informed Consent & Authorization Toolkit for Minimal Risk … Executive Collaborates To Develop and Implement a Plan Addressing Safety Issues
Considers patient risks … Involves frontline providers to help reduce risks. … Meet with hospital departments (risk management, quality improvement) to ensure that L&D CUSP efforts … Managing the Risk of Learning: Psychological Safety in Work Teams. In West M, ed.
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cahps.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/teamstepps/instructor/scenarios/CombatCare.pdf
March 18, 2014 - Although not life threatening, the error placed the patient at
unnecessary risk, delayed his disposition … Instructor Comments
This scenario illustrates the potential risks of low workload. … Instructor Comments
This scenario illustrates the potential risks of low workload.
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cahps.ahrq.gov/health-literacy/professional-training/shared-decision/tool/resource-7.html
September 01, 2020 - Opportunity Guidance
AHRQ Grants Policy Notices
AHRQ Informed Consent & Authorization Toolkit for Minimal Risk … aids, treatment summaries, and educational materials that have culturally relevant descriptions of risks … important concept—such as treatment options, participation in a clinical trial, weighing benefits and risk
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cahps.ahrq.gov/hai/cusp/modules/apply/ac-cusp.html
December 01, 2012 - Understanding Risk and Human Behavior Slide 7. Managing Error and Risk Slide 8. … At-risk behavior—Choosing to behave in a way that increases risk, where risk is not recognized or is … Managing Error and Risk
Say:
To improve outcomes, human error, at-risk behavior, and reckless … To achieve optimal outcomes, organizations must design robust systems that minimize risks. … It is critical to reinforce behaviors that will reduce risk and deter behaviors that increase risk.
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cahps.ahrq.gov/patient-safety/settings/hospital/fall-prevention/workshop/module-3/slides.html
September 01, 2017 - Slide 14: Fall Risk Assessment
Slide 15: Step 1: Fall Risk Screening/Assessment
Use a reliable … Add unit-level risk factors as needed. … Other risks:
IV pole.
Orthostatic hypotension.
Oxygen tubing. … Image: Paper labeled “fall risk.” … Choose a tool for assessing risk factors.