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Showing results for "system".

161. In Conversation with Lucy Savitz about Learning Health Systems for Patient Safety | PSNet
     psnet.ahrq.gov/perspective/conversation-lucy-savitz-about-learning-health-systems-patient-safety
     February 26, 2025 - Working in a healthcare delivery system, we collect a ton of data. … There is a lot of waste in the system. … other health system partners went there to observe what they did. … During that time, the health system probably has a new problem. … Background A learning health system is a health system (i.e., a group of one or more healthcare organizations

162. Understanding the barriers to physician error reporting and disclosure: a systemic approach to a systemic problem. | PSNet
     psnet.ahrq.gov/issue/understanding-barriers-physician-error-reporting-and-disclosure-systemic-approach-systemic
     January 12, 2022 - with clinical and cost outcomes among surgical patients in a large integrated health care delivery system … prescribing and patient pain in opioid-naive patients undergoing elective surgery in a large American health system

163. Systems Approach in Healthcare. | PSNet
     psnet.ahrq.gov/issue/systems-approach-healthcare
     June 21, 2006 - June 15, 2011 The influence of formulation and medicine delivery system on medication

164. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/867655/psn-pdf
     February 26, 2025 - Background A learning health system is a health system (i.e., a group of one or more healthcare organizations … The role of a learning health system is to foster this analysis and shared learning. … The learning healthcare system: where are we now? A systematic review. … Health technology, quality and safety in a learning health system. … Learn from every patient: how a learning health system can improve patient care.

165. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/867223/psn-pdf
     December 04, 2024 - "It is not the fault of the health care team - it is the way the system works": a mixed-methods quality … patients with advanced cancer and family members reveals challenges navigating a fragmented healthcare system … “It is not the fault of the health care team - it is the way the system works”: a mixed-methods quality … https://psnet.ahrq.gov/issue/it-not-fault-health-care-team-it-way-system-works-mixed-methods-quality- … caregivers reported lower quality of care, lower quality of life, and worse trust in the healthcare system

166. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/867340/psn-pdf
     December 11, 2024 - Multiple points of system failure underpin continuous subcutaneous infusion safety incidents in palliative … Multiple points of system failure underpin continuous subcutaneous infusion safety incidents in palliative … https://psnet.ahrq.gov/issue/multiple-points-system-failure-underpin-continuous-subcutaneous-infusion … palliative care continuous subcutaneous infusions submitted to the National Reporting and Learning System … Potential system- based solutions were proposed to replace human-based solutions.

167. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/866249/psn-pdf
     July 10, 2024 - Implementation of a health information technology safety classification system in the Veterans Health … Implementation of a health information technology safety classification system in the Veterans Health … https://psnet.ahrq.gov/issue/implementation-health-information-technology-safety-classification-system … retrospectively reviewed and classified into one of five types: HIT failures, unmet user needs, external system … https://psnet.ahrq.gov/issue/implementation-health-information-technology-safety-classification-system-veterans-health

168. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/867082/psn-pdf
     November 06, 2024 - Learning in radiation oncology: 12-month experience with a new incident learning system. … month experience with a new incident learning system. … https://psnet.ahrq.gov/issue/learning-radiation-oncology-12-month-experience-new-incident-learning- system … An incident learning system (ILS) can highlight system weaknesses and promote organizational learning … https://psnet.ahrq.gov/issue/learning-radiation-oncology-12-month-experience-new-incident-learning-system

169. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/836965/psn-pdf
     April 20, 2022 - We are not there yet: a qualitative system probing study of a hospital rapid response system. … We are not there yet: a qualitative system probing study of a hospital rapid response system. … - system Rapid response systems (RRS) are widely used to identify signs of rapid deterioration among … https://psnet.ahrq.gov/issue/we-are-not-there-yet-qualitative-system-probing-study-hospital-rapid-response-system … https://psnet.ahrq.gov/issue/we-are-not-there-yet-qualitative-system-probing-study-hospital-rapid-response-system

170. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/867599/psn-pdf
     January 22, 2025 - Assessing patient work system factors for medication management during transition of care among older … Assessing patient work system factors for medication management during transition of care among older … https://psnet.ahrq.gov/issue/assessing-patient-work-system-factors-medication-management-during- transition-care-among … This article describes the development and evaluation of measures of patient work-system factors in … The authors suggest that patient work-system factors be assessed before transitions to home to identify

171. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/838304/psn-pdf
     October 12, 2022 - The effect of a system-level tiered huddle system on reporting patient safety events: an interrupted … The effect of a system-level tiered huddle system on reporting patient safety events: an interrupted … https://psnet.ahrq.gov/issue/effect-system-level-tiered-huddle-system-reporting-patient-safety-events … https://psnet.ahrq.gov/issue/effect-system-level-tiered-huddle-system-reporting-patient-safety-events-interrupted-time … https://psnet.ahrq.gov/issue/effect-system-level-tiered-huddle-system-reporting-patient-safety-events-interrupted-time

172. Rapid response systems. | PSNet
     psnet.ahrq.gov/issue/rapid-response-systems
     September 30, 2010 - Cardiopulmonary arrest and mortality trends, and their association with rapid response system … April 25, 2016 The medical emergency team system and not-for-resuscitation orders: results … January 4, 2012 The impact of introducing medical emergency team system on the documentations … January 18, 2011 Introduction of the medical emergency team (MET) system: a cluster-randomised … Problems and solutions arising during a study in visual semantics of the medical emergency team system

173. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/867392/psn-pdf
     December 18, 2024 - Large-scale observational study of AI-based patient and surgical material verification system in ophthalmology … Large-scale observational study of AI-based patient and surgical material verification system in ophthalmology … psnet.ahrq.gov/issue/large-scale-observational-study-ai-based-patient-and-surgical-material- verification-system … The AI system was integrated with the WHO surgical safety checklist for patient identification, surgical … detected five errors (compared with one error pre- implementation), four of which occurred when the AI system

174. Safer Clinical Systems. | PSNet
     psnet.ahrq.gov/issue/safer-clinical-systems
     December 04, 2015 - Multi-use Website Safer Clinical Systems. Citation Text: Safer Clinical Systems. London, UK: Health Foundation. Copy Citation Save Save to your library Print Download PDF Share Facebook Twitter Linkedin Copy URL …

175. When systems fail. | PSNet
     psnet.ahrq.gov/issue/when-systems-fail
     February 10, 2011 - Download Citation Related Resources From the Same Author(s) A computer alert system … June 22, 2022 The Veterans Affairs root cause analysis system in action.

176. Enhancing Surgical Systems. | PSNet
     psnet.ahrq.gov/issue/enhancing-surgical-systems
     April 12, 2017 - Special or Theme Issue Enhancing Surgical Systems. Citation Text: Enhancing Surgical Systems. Healey AN, Catchpole K, Yule S, eds. Cogn Tech Work. 2008;10(4):249-333.   Copy Citation Save Save to your library Print Download PDF Share …

177. Rapid response systems. | PSNet
     psnet.ahrq.gov/issue/rapid-response-systems-0
     April 07, 2010 - Review Rapid response systems. Citation Text: Rapid response systems. Stevens JP. UpToDate. July 18, 2024. Copy Citation Save Save to your library Print Download PDF Share Facebook Twitter Linkedin Copy URL J…

178. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/867345/psn-pdf
     December 11, 2024 - Implementation of a high-reliability organization framework in a large integrated health care system … Implementation of a high-reliability organization framework in a large integrated health care system … psnet.ahrq.gov/issue/implementation-high-reliability-organization-framework-large-integrated-health- care-system … In 2019, the VA implemented a system-wide quality improvement initiative to become a high reliability … psnet.ahrq.gov/issue/implementation-high-reliability-organization-framework-large-integrated-health-care-system

179. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/864380/psn-pdf
     March 13, 2024 - Stepped-wedge cluster RCT to assess the effects of an electronic medication system on medication administration … Stepped-wedge cluster RCT to assess the effects of an electronic medication system on medication administration … https://psnet.ahrq.gov/issue/stepped-wedge-cluster-rct-assess-effects-electronic-medication-system- … This randomized trial investigated the impact of an electronic medication system on medication administration … https://psnet.ahrq.gov/issue/stepped-wedge-cluster-rct-assess-effects-electronic-medication-system-medication

180. Psn-Pdf (pdf file)
     psnet.ahrq.gov/node/865677/psn-pdf
     April 24, 2024 - The impact of adding a 2-way video monitoring system on falls and costs for high-risk inpatients. … The impact of adding a 2-way video monitoring system on falls and costs for high-risk inpatients. … https://psnet.ahrq.gov/issue/impact-adding-2-way-video-monitoring-system-falls-and-costs-high-risk- … monitoring (VM) plus in-person sitters on falls among high-risk patients at one academic hospital system … https://psnet.ahrq.gov/issue/impact-adding-2-way-video-monitoring-system-falls-and-costs-high-risk-inpatients