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Showing results for "thing".

  1. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/39381/psn-pdf
    March 17, 2010 - Getting it right when things go wrong. March 17, 2010 Pettker CM, Funai EF. Getting it right when things go wrong. JAMA. 2010;303(10):977-8. doi:10.1001/jama.2010.256. https://psnet.ahrq.gov/issue/getting-it-right-when-things-go-wrong This brief commentary discusses the relationship between blame, accountability, …

  2. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/61083/psn-pdf
    October 28, 2020 - The other thing is that it's almost playing out as a moral discussion. … CC: One unique thing about our industry is that we integrate with a lot of other sites and services and

  3. In Conversation With… Gregg S. Meyer, MD, MSc | PSNet

    psnet.ahrq.gov/perspective/conversation-gregg-s-meyer-md-msc
    June 01, 2016 - The good news is that for many health care organizations, handwriting errors are now a thing of the past … One thing we underappreciated was the importance of culture. … The final thing is that we were very impatient. Everyone wanted to be able to "fix the problem." … terrific when they walked through my door and they said, "I'm interested in the safety and quality thing … One thing I found incredibly gratifying and extraordinarily useful to me personally, but to some extent

  4. In Conversation with... Charles Ornstein | PSNet

    psnet.ahrq.gov/perspective/conversation-charles-ornstein
    October 01, 2009 - RW: You mentioned that there was a second thing that happened? … CO: The second thing that had us interested in the hospitals was less to do with direct patient care … you have to face up to the harsh reality that a mistake was made, patients may have died, and the key thing … The other thing that's important for reporters is not just to say when a particularly bad case happens … RW: Was there some moment when you shifted on your thinking and felt like the best thing to do was to

  5. The Media: An Essential, If Sometimes Arbitrary, Promoter of Patient Safety | PSNet

    psnet.ahrq.gov/perspective/media-essential-if-sometimes-arbitrary-promoter-patient-safety
    October 01, 2009 - RW: You mentioned that there was a second thing that happened? … CO: The second thing that had us interested in the hospitals was less to do with direct patient care … you have to face up to the harsh reality that a mistake was made, patients may have died, and the key thing … The other thing that's important for reporters is not just to say when a particularly bad case happens … RW: Was there some moment when you shifted on your thinking and felt like the best thing to do was to

  6. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/33849/psn-pdf
    January 01, 2018 - RW: One thing I've taken from your writing is there's something about copy and paste that is operational … by hand, the tradition was you would then commit yourself to say: I think this is the most likely thing … , here's maybe the second or the third likely thing, and I propose addressing this by doing such and … They just repeat the same thing day after day.

  7. In Conversation With... Edwin Loftin, DNP, MBA, RN, NEA-BC-FACHE | PSNet

    psnet.ahrq.gov/perspective/conversation-edwin-loftin-dnp-mba-rn-nea-bc-fache
    August 31, 2020 - The other thing I’d like to discuss is this link between person and family engagement and its impact … We know who's going to be doing the right thing and have the integrity of doing it when nobody is looking … I know this same type of thing has happened in other nursing teams as I talk to other CNOs. … We may have to try five things, fifty things, before you get to the right thing for this, and then what's

  8. Safety Across The Board | PSNet

    psnet.ahrq.gov/perspective/safety-across-board
    August 31, 2020 - The other thing I’d like to discuss is this link between person and family engagement and its impact … We know who's going to be doing the right thing and have the integrity of doing it when nobody is looking … I know this same type of thing has happened in other nursing teams as I talk to other CNOs. … We may have to try five things, fifty things, before you get to the right thing for this, and then what's

  9. In Conversation With… Maureen Bisognano | PSNet

    psnet.ahrq.gov/perspective/conversation-maureen-bisognano
    February 26, 2025 - particularly people feeling like they have been working very hard at these things and it's just one thing … safety field was founded on the principle that it's largely about good people trying to do the right thing

  10. In Conversation With… J. Bryan Sexton, PhD, MA | PSNet

    psnet.ahrq.gov/perspective/conversation-j-bryan-sexton-phd-ma
    February 26, 2025 - Robert Wachter, Editor, AHRQ WebM&M : One thing that you pioneered was a focus on how people interact … complicated than that, but it sure felt good to be able to point to something and say: This is the thing

  11. The PeaceHealth Governance Journey in Support of Quality and Safety | PSNet

    psnet.ahrq.gov/perspective/peacehealth-governance-journey-support-quality-and-safety
    August 01, 2007 - In short, it is the board's responsibility to ensure that the organization does the right thing for every … The second thing that happened in many hospitals was that they had a shocking incident. … Well, it turns out that one thing they do is promote a conversation between members of the board and … over to other aspects of quality as well, not just the safety agenda, which frankly would be a great thing

  12. In Conversation with...James L. Reinertsen, MD | PSNet

    psnet.ahrq.gov/perspective/conversation-withjames-l-reinertsen-md
    August 01, 2007 - The second thing that happened in many hospitals was that they had a shocking incident. … Well, it turns out that one thing they do is promote a conversation between members of the board and … over to other aspects of quality as well, not just the safety agenda, which frankly would be a great thing … In short, it is the board's responsibility to ensure that the organization does the right thing for every

  13. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43969/psn-pdf
    November 17, 2017 - Transparency when things go wrong: physician attitudes about reporting medical errors to patients, peers, and institutions. November 17, 2017 Bell SK, White AA, Yi JC, et al. Transparency When Things Go Wrong. J Patient Saf. 2015;13(4):243-248. doi:10.1097/pts.0000000000000153. https://psnet.ahrq.gov/issue/transp…

  14. Openness and Honesty When Things Go Wrong: the Professional Duty of Candour. | PSNet

    psnet.ahrq.gov/issue/openness-and-honesty-when-things-go-wrong-professional-duty-candour
    October 04, 2017 - Book/Report Openness and Honesty When Things Go Wrong: the Professional Duty of Candour. Citation Text: Openness and Honesty When Things Go Wrong: the Professional Duty of Candour. London, UK: General Medical Council and the Nursing and Midwifery Council; June 29, 2015. Copy Citation …

  15. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/42943/psn-pdf
    April 12, 2014 - Doing right by our patients when things go wrong in the ambulatory setting. April 12, 2014 Schiff G, Griswold P, Ellis BR, et al. Doing right by our patients when things go wrong in the ambulatory setting. Jt Comm J Qual Patient Saf. 2014;40(2):91-96. https://psnet.ahrq.gov/issue/doing-right-our-patients-when-thin…

  16. The Role of the Patient in Improving Patient Safety | PSNet

    psnet.ahrq.gov/perspective/role-patient-improving-patient-safety
    March 01, 2007 - It was a system thing. … From what I see and hear, it's constantly a communication thing. … But the more important thing about that story was that the hospital and the family came together and … The second thing I'm most proud of is all the good stuff that we've done since she's died.

  17. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/44132/psn-pdf
    May 13, 2015 - Adverse outcomes: why bad things happen to good people. May 13, 2015 Sonnenberg A. Adverse outcomes: why bad things happen to good people. Clin Gastroenterol Hepatol. 2015;13(5):820-3.e1. doi:10.1016/j.cgh.2014.07.064. https://psnet.ahrq.gov/issue/adverse-outcomes-why-bad-things-happen-good-people This commentary…

  18. In Conversation with David W. Bates about Are We Safer Today? | PSNet

    psnet.ahrq.gov/perspective/conversation-david-w-bates-about-are-we-safer-today
    February 26, 2025 - It is an obvious thing, although the definition can be tricky. … The first thing you have to figure out is if the diagnosis is wrong, and I think artificial intelligence

  19. Are We Safer Today? | PSNet

    psnet.ahrq.gov/perspective/are-we-safer-today
    February 26, 2025 - It is an obvious thing, although the definition can be tricky. … The first thing you have to figure out is if the diagnosis is wrong, and I think artificial intelligence

  20. Psn-Pdf (pdf file)

    psnet.ahrq.gov/node/43749/psn-pdf
    December 10, 2014 - Alarm management: first things first: using reliable data to eliminate unnecessary alarms. December 10, 2014 Vanderveen T. Patient Saf Qual Healthc. November/December 2014;11:38-40,42-45. https://psnet.ahrq.gov/issue/alarm-management-first-things-first-using-reliable-data-eliminate-unnecessary- alarms Spotlightin…
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