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  1. psnet.ahrq.gov/perspective/operationalizing-patient-safety-academic-medical-centers
    August 01, 2010 - Building a high reliability organization through a multi-method approach to monitoring the practice environment … Med Teach. 2005;27:298-3016. [go to PubMed] 24. Walton MM, Shaw T, Barnet S, Ross J. … [go to PubMed]     Figure Back to Top Figure. … How many times does the procedure have to be interrupted because the proceduralist doesn't have what … What is different in academic medicine is the opportunity to engage workers in process-improvement methods
  2. psnet.ahrq.gov/web-mm/coming-undone-failure-closure-device
    April 01, 2006 - complications related to the retroperitoneal hematoma, including persistent fever, leukocytosis, ileus, and back … catheterization, the sheath in the femoral artery is removed, and hemostasis is achieved from one of several methods … Manual compression of the artery is the traditional method and is easy to perform, but it is associated … laboratory abnormalities that should raise suspicion of retroperitoneal bleed include hypotension, back … Cardiac catheterization is one of the most commonly performed procedures in medical practice and has
  3. www.ahrq.gov/sites/default/files/publications/files/clabsicompanion.pdf
    October 18, 2012 - ................................................................................... 27 Estimation Method … Within the Methods section, a data collection schedule and details on calculations can be found. … considered (e.g. costs billed, actual costs, etc.), and estimation model utilized (e.g. matching procedure … consumer price index inpatient hospital services index Data as of: October 15th, 2012 30 Estimation Method … beginning of the project quarter (i.e. month 1), the numbers of the first available month were carried back
  4. psnet.ahrq.gov/perspective/what-have-we-learned-about-safe-inpatient-handovers
    March 01, 2011 - Effectiveness of a course designed to teach handoffs to medical students. … Very few people are using read back even though it's been suggested. … one-on-one exchange and can be haphazard if the person they're signing out to is in the middle of a procedure … 2020 Implementation and sustainability of a medication reconciliation toolkit: a mixed methods … Multicenter development, implementation, and patient safety impacts of a simulation-based module to teach
  5. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/73906/psn-pdf
    October 06, 2021 - emergency and what’s normal and who to ask if she's not sure, and that she feels like she’d want to come back … stay, she might go home and have a headache and have high blood pressure and say, “Well I’m not going back … devices], and to be provided instructions for their follow-up care, and then we see that they can't fall back … resultant consequences, and I'm wondering if there's an opportunity to integrate some of those safety methods … to do with this hypertension curriculum idea is to build the model for what it looks like to really teach
  6. hcup-us.ahrq.gov/db/nation/neds/NEDS_Introduction_2007.jsp
    January 01, 2007 - CPT procedure codes also provide valuable insight into the procedures performed. … ICD-9-CM procedure information PR_ED1 – PR_ED9 ICD-9-CM procedures performed in ED PRCCS_ED1 … – PCLASS_ED9 Procedure class for all ICD-9-CM procedures: (1) Minor Diagnostic, (2) Minor Therapeutic … PCLASS_IP1 – PCLASS_IP9 Procedure class for all ICD-9-CM procedures: (1) Minor Diagnostic, (2) … Privacy Notice , Viewers & Players Last modified 6/23/16 Back to Top
  7. hcup-us.ahrq.gov/db/nation/neds/NEDS_Introduction_2006.jsp
    January 01, 2006 - CPT procedure codes also provide valuable insight into the procedures performed. … ICD-9-CM procedure information PR_ED1 – PR_ED9 ICD-9-CM procedures performed in ED PRCCS_ED1 … – PCLASS_ED9 Procedure class for all ICD-9-CM procedures: (1) Minor Diagnostic, (2) Minor Therapeutic … PCLASS_IP1 – PCLASS_IP9 Procedure class for all ICD-9-CM procedures: (1) Minor Diagnostic, (2) … Privacy Notice , Viewers & Players Last modified 6/23/16 Back to Top
  8. www.ahrq.gov/hai/cauti-tools/guides/implguide-pt3.html
    October 01, 2015 - measurement of urinary output in critically ill patients —Indwelling urinary catheters are the only method … Use audits and observations of practice and ensure that collected data are reported back to staff doing … this procedure. … Use case scenarios to teach best use of the nurse-driven protocol for removal of catheters. … Teach about appropriate care of acute urinary retention that may occur.
  9. www.ahrq.gov/sites/default/files/publications2/files/dxsafety-issuebrief-education.pdf
    March 11, 2022 - diagnostic error, as repeated studies have shown.6, 27, 28 Some of the origins of this problem trace back … In addition, health professions education programs have been slow to adopt evidence-based methods to … , what to teach, how to teach it, and how to assess it? … training in this area should translate into specific skills and practices regarding effective listening, teach-back … Clinical reasoning assessment methods: a scoping review.
  10. www.ahrq.gov/sites/default/files/2024-02/gurwitz2-report.pdf
    January 01, 2024 - other resources.37,38) The clinical pharmacist reviewed materials with the patient/caregiver, using teach-backTeach-back is a way to confirm that a healthcare provider has explained to patients what they need to … Each review followed a standardized procedure, searching for signals possibly indicating a clinically … Observation method of detecting medication errors. … Always Use Teach Back! http://www.ihi.org/resources/Pages/Tools/AlwaysUseTeachBack!.aspx.
  11. psnet.ahrq.gov/web-mm/slippery-slide-life
    January 21, 2017 - responsibility for independent practice, a model sometimes derisively referred to as “see one, do one, teach … who understand principles of adult education, appreciate the limitations of traditional educational methodsMethods to educate and train future generations of health care professionals must evolve away from … traditional lecture-based techniques and embrace new modalities in order to effectively teach patient … language used in the delivery room often is not standardized, important communications are rarely read back
  12. psnet.ahrq.gov/web-mm/workaround-error
    October 30, 2024 - Nurses often improvise to save time and steps by using portable carts instead of making trips back and … Because of this, a recent Institute of Medicine (IOM) report recommended that hospitals should scale back … Hospitals should scale back the workload of their staff nurses to achieve safe nurse-to-patient ratios … IOM report: Hospitals must cut back workload and hours of nurses to maintain patient safety. … A mixed method study.
  13. effectivehealthcare.ahrq.gov/sites/default/files/related_files/surveillance-report-1-nonopioid-pharm-chronic-pain.pdf
    April 01, 2022 - We utilized the same methods for data abstraction and quality assessment as for the original report. … Risk of bias (quality) was assessed using criteria and methods developed by the Cochrane Back and Neck … Methods Research Report. … AND ('clinical trial'/de OR 'randomized controlled trial'/de OR 'randomization'/de OR 'single blind procedure … '/de OR 'double blind procedure'/de OR 'crossover procedure'/de OR 'placebo'/de OR 'prospective study
  14. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/863641/psn-pdf
    February 28, 2024 - Research has found that active learning methods (e.g., simulations, discussions) are more effective … for retaining information and supporting attitude and behavioral changes than passive learning methods … explanation of the value of the TeamSTEPPS curriculum, and guidance for instructors or trainers who teach
  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33779/psn-pdf
    March 01, 2015 - Patient summary, Action list, Situational awareness and contingency planning, and Synthesis or read-back
  16. psnet.ahrq.gov/perspective/conversation-withj-bryan-sexton-phd-ma
    December 01, 2006 - Is everyone familiar with the procedure? Well, here's the operative plan and here's plan B. … By doing that before every procedure, you build an expectation in all the workers' minds that they will … Our assessment method is that you measure things hospital wide, but capture information at the patient … RW: How do you relate this back to a policy level? BS: Keep it evidence based, period. … Policy, Management, and BehaviorSchool of Public Health, University of Albany, SUNY References Back
  17. psnet.ahrq.gov/perspective/conversation-hardeep-singh-md-mph
    January 01, 2014 - There wasn't any looking back after that—I finally got a K23 grant [a larger 5-year faculty development … HS : Absolutely, and that goes back to the time that I was in practice. … It also called for rigorous new evaluation methods to be developed and implemented in both medical schools
  18. hcup-us.ahrq.gov/reports/statbriefs/sb205-Hospital-Discharge-Postacute-Care.jsp
    May 01, 2016 - Summary Trend Tables Findings-At-A-Glance Publications Information About Using HCUP Data Methods … The highest rate of discharge to PAC was another orthopedic procedure—hip and femur procedures—for which … HCUP Methods Series Report #2015-07. September 1, 2015. U.S. … http://www.hcup-us.ahrq.gov/reports/methods/2015-07.pdf . … Privacy Notice , Viewers & Players Last modified 6/23/16 Back to Top
  19. psnet.ahrq.gov/perspective/becoming-certified-professional-patient-safety-registered-nurses-perspective
    June 01, 2016 - How does that change the thinking about the content and the methods of both training and certification … As you reflect back over 15 or 20 years of experience, has anything surprised you in terms of content … GM : I often reflect back on the honor and privilege I had to be there at the beginning of the federal … A few years ago for the series, I called him back to do an update on safety culture . … When I think back to my days at AHRQ, we had a fantasy that something like this would begin to happen
  20. digital.ahrq.gov/sites/default/files/docs/citation/r01hs022086-carayon-final-report-2019.pdf
    January 01, 2019 - Using these procedures, the response rate for nurses was 86%. … 18]. 2.2.5 Data Collection Instruments 2.2.5.1 Interviews We used a modified Critical Decision Method … Order read-back, telehealth Defined roles Structure for rounds and shift change Provide structure … , and needs to be re-initialized after the procedure. … MacGregor, Critical decision method for eliciting knowledge.

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