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Showing results for "the change teams".

3301. Remote Patient Monitoring | PSNet
      psnet.ahrq.gov/perspective/remote-patient-monitoring
      March 15, 2023 - hospital utilization and detecting any change in status of patients. … For example, when you can graph the vitals, you can highlight the data supplied by the patient and the … The company will help deploy the technology, do the monitoring, and transmit documentation of the twenty … scenario, where we see real-time vital signs, utilize telehealth, and work with a family caregiver to change … You can change treatment plans based remote monitoring data.

3302. In Conversation with... Dr. Neal Sikka and Dr. Colton Hood about Remote Patient Monitoring | PSNet
      psnet.ahrq.gov/perspective/conversation-dr-neal-sikka-and-dr-colton-hood-about-remote-patient-monitoring
      March 15, 2023 - For example, when you can graph the vitals, you can highlight the data supplied by the patient and the … The company will help deploy the technology, do the monitoring, and transmit documentation of the twenty … scenario, where we see real-time vital signs, utilize telehealth, and work with a family caregiver to change … You can change treatment plans based remote monitoring data. … hospital utilization and detecting any change in status of patients.

3303. Too Hot For Comfort | PSNet
      psnet.ahrq.gov/web-mm/too-hot-comfort
      May 19, 2015 - The nurses further assessed the site and removed the IV. … Within the next hour, the nurse coming on shift assessed the infant further and discovered redness and … a burn at the site as a result of the warm compress. … to entertain the possibility that the "burn" in this case may have been the result of extravasation … Cooling of the burn wound: the ideal temperature of the coolant. Burns. 2007;33:917-922.

3304. Surprise Wire | PSNet
      psnet.ahrq.gov/web-mm/surprise-wire
      July 15, 2020 - On the day of transfer, the ICU nurse removed the patient’s femoral catheter but discovered the guidewire … (used at the time of placement in the ED) still in the patient's femoral vein. … guidewire in place and failed to account for the missing guidewire at the end of the procedure. … and the kit from the supply cart prior to the procedure, increasing the likelihood that a non-air occlusive … November 16, 2022 Rapid response teams seen through the eyes of the nurse.

3305. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/50768/psn-pdf
      December 27, 2019 - CB: I’m the Co-Chair of the HHS Health Literacy Workgroup. … minimal context about the care of the patient. … The approach that the toolkit took was to create a separate tool called “How to deliver the re-engineered … The Standards operationalize the definition. … The language assistance piece is by far the most developed and has made the most head way in health

3306. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/33651/psn-pdf
      June 01, 2007 - RW: Talk a little bit about the genesis of the system and maybe even the politics. Who proposed it? … The legislation came from MAPS and was supported by the Medical Association, the Hospital Association … , and the Department of Health from the get go, as well as by the Governor, which probably made it a … RW: It's a little bit surprising that the hospitals would have been on board from the get go with the … what the point of the system is.

3307. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49397/psn-pdf
      May 01, 2003 - The Dropped Lung May 1, 2003 Heffner JR. The Dropped Lung. PSNet [internet]. 2003. … The residents caring for the patient interpreted the white-out as a large pleural effusion, and diagnostic … Of greatest concern is the needlessness of the procedure. … The chest x-ray demonstrated a mediastinum shifted toward the affected side. … The nature of conceptual understanding in biomedicine: The deep structure of complex ideas and the development

3308. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49725/psn-pdf
      January 01, 2015 - from the pulmonary artery into the right ventricle when he performed the actual ablation. … In the ICU, the nurse who assumed care of the patient noticed that the PA catheter waveform was dampened … Fortunately, the nurse recognized the situation quickly, and the resident deflated the balloon and withdrew … the final segment of the case. … Automatic resistance to the implementation of checklists (it's a change, a possible slight increase in

3309. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/49466/psn-pdf
      October 14, 2004 - The physician did not see the form, and the patient continued to receive thickened liquids. … This protocol, now in effect, permits the speech pathologist to write the order to make the patient … speech therapist to communicate the need to change the diet orders in a more timely and direct fashion … the primary team to do the same. … This effectively reduces the possibility of aspiration from the time of the physician's order to the

3310. Training Catalog | PSNet
      psnet.ahrq.gov/training-catalog
      June 01, 2025 - , their teams, and themselves as providers. … All content will be accessible for six weeks following the conclusion of the program, ensuring you have … ample time to absorb and apply the knowledge. … Allied Health Professions Event Description: Educational webinars support fall risk reduction teams … For webinars and practical tools to improve fall risk reduction, click on the topic links in the menu

3311. Patient Safety 101 | PSNet
      psnet.ahrq.gov/primer/patient-safety-101
      January 16, 2025 - Background The History of the Patient Safety Movement The concept that patients could be harmed while … The term iatrogenesis —still used today to indicate harm experienced by patients at the hands of the … Reason's work led to the development of the systems approach , which takes the view that most errors … The systems approach seeks to identify situations or factors likely to give rise to human error and change … Another challenge for the field is the need to improve safety across the continuum of care.

3312. In Conversation With… Lawrence Smith, MD | PSNet
      psnet.ahrq.gov/perspective/conversation-lawrence-smith-md
      February 01, 2012 - the patient with the resident team engaged in the care probably winds up better for the patient. … They accept whatever is the culture and the rules of the game within residency. … LS : That was the implication of the conversation. … It's different than trading the retractor for the scissors. The technology is racing ahead. … The death of 18-year-old Libby Zion at The New York Hospital in 1984 led to the recommendation by the

3313. Identifying Adverse Events Not Present on Admission: Can We Do It? | PSNet
      psnet.ahrq.gov/perspective/identifying-adverse-events-not-present-admission-can-we-do-it
      October 01, 2008 - care, to measure and compare quality and patient safety, and even to change provider incentives through … can be expected to change. … Do you see evidence of this policy actually creating some change at the system level? … focus is not likely to occur, if there is no business case for change. … every time is probably the weakest method of systems change.

3314. In Conversation With…David C. Classen, MD, MS | PSNet
      psnet.ahrq.gov/perspective/conversation-withdavid-c-classen-md-ms
      May 01, 2012 - You can intervene in real time to change the dose and stop or modify the drug dosage. … Basically, even if you combine the AHRQ PSIs and the voluntary reporting system—they missed 90% of the … DC : In an analysis conducted at one of the hospitals looking at the sensitivity and specificity of the … The cascading of events that occurred in the Medicare study—more than a quarter of the patients had them … This methodology was valuable in the early days of the patient safety field by highlighting the major

3315. The Emergence of the Trigger Tool as the Premier Measurement Strategy for Patient Safety | PSNet
      psnet.ahrq.gov/perspective/emergence-trigger-tool-premier-measurement-strategy-patient-safety
      May 01, 2012 - The Emergence of the Trigger Tool as the Premier Measurement Strategy for Patient Safety Paul J. … The Emergence of the Trigger Tool as the Premier Measurement Strategy for Patient Safety. … The Emergence of the Trigger Tool as the Premier Measurement Strategy for Patient Safety. … You can intervene in real time to change the dose and stop or modify the drug dosage. … The Emergence of the Trigger Tool as the Premier Measurement Strategy for Patient Safety.

3316. Psn-Pdf (pdf file)
      psnet.ahrq.gov/node/50858/psn-pdf
      January 31, 2020 - The use of AI in radiology has the potential to improve the efficiency and efficacy of medical imaging … .2 When conducting an imaging study, the use of AI can improve the quality of the image captured. … AI systems can detect at the time of imaging whether the quality of the data acquired is optimal for … The first is in the evaluation of the AI technology and determining what level of accuracy is required … AI systems are not as equipped as humans to recognize when there is a relevant change in context or

3317. In Conversation with Carole Stockmeier about Zero Harm: Striving to Reduce Preventable Harms – Point, Counterpoint, and Areas of Agreement | PSNet
      psnet.ahrq.gov/perspective/conversation-carole-stockmeier-about-zero-harm-striving-reduce-preventable-harms-point
      September 24, 2024 - And, when we do have an event of harm, the role of the leader is to help the organization pick itself … , the day-to-day words and actions of the organization. … These kinds of leading and real-time indicators are the right focal point in the effort to change outcomes … The practices of organizations leading the way will hopefully become the tipping point for making the … The CMS structural measure is a push in the right direction and in the right way. 

3318. Missed Compartment Syndrome after Steep Lithotomy Position for Laparoscopic Gynecological Surgery | PSNet
      psnet.ahrq.gov/web-mm/missed-compartment-syndrome-after-steep-lithotomy-position-laparoscopic-gynecological
      January 29, 2021 - The common peroneal nerve can be injured if it is compressed between the stirrup and the fibula. 1 The … For each centimeter that the ankles are elevated above the heart, the arterial pressure in the calf muscles … They elevate the pressure transducer of the arterial line to the level of the ear to measure and record … The calf muscles, however, are not given the same priority as the brain. … The more extreme the lithotomy and Trendelenburg positions, the higher the blood pressure needed for

3319. From Possible to Probable to Sure to Wrong—Premature Closure and Anchoring in a Complicated Case | PSNet
      psnet.ahrq.gov/web-mm/possible-probable-sure-wrong-premature-closure-and-anchoring-complicated-case
      October 02, 2013 - Subsequent review of the case, including the clinical documentation, noted that the provisional diagnosis … vasculitis during the ensuing outpatient follow-up, in both the minds of the clinicians and the chart … Neuroimaging was the correct choice of subsequent diagnostic tests, but the CT scan of the brain was … by the team. … about the incorrectness of the working diagnosis.

3320. EMS Patient Safety in the Field | PSNet
      psnet.ahrq.gov/perspective/ems-patient-safety-field
      July 28, 2021 - Following the 911 call, the 911 center personnel must triage the call to ensure that, based on the information … That’s just the beginning of the process. … The same with stroke, the same with acute MIs, the same with delivering babies, the same with very sick … that the extrication of the patient took place; that the patient was transported; and that the EMS personnel … and to really take the care to the people.