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psnet.ahrq.gov/issue/current-and-ideal-state-anatomic-pathology-patient-safety
February 15, 2010 - Emphasizing how differences between slow thinking and fast thinking can cause interpretation errors
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psnet.ahrq.gov/issue/sensemaking-organizations
June 20, 2018 - Weick's thinking encompasses the notion that both individuals and teams often overlook important problems … July 24, 2019
Utilizing a Systems and Design Thinking Approach for Improving Well-Being
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effectivehealthcare.ahrq.gov/sites/default/files/pdf/coronary-artery-stenting_research-protocol.pdf
August 19, 2011 - We plan to evaluate the impact of IVDx techniques on the diagnostic thinking of physicians. … what is the impact of using an IVDx technique—when compared to angiography alone—
on the diagnostic thinking … success of PCI immediately after the procedure—when
compared to angiography alone—on the diagnostic thinking … Diagnostic thinking and therapeutic decisionmaking outcomes include:
• KQ 1: During diagnostic workup … Timing
• Any duration of followup
Study designs of interest
• For diagnostic thinking and
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psnet.ahrq.gov/perspective/conversation-mark-l-graber-md
January 01, 2016 - Our Society [SIDM] thought if we could convince the IOM to undertake a major report on diagnostic error … Where did that come out in the committee's deliberations, and what are your thoughts about that? … This is where we document our thoughts, find our information, and communicate with others. … interventions are rigorously evaluated.( 14,15 ) Our work ahead should also define how to maintain our critical … thinking skills, particularly in an environment of increasingly complex and automated technologies.(
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psnet.ahrq.gov/issue/continuous-improvement-patient-safety-case-change-nhs
December 20, 2023 - Thinking About Learning for Improvement in Health Care. … Thinking About Learning for Improvement in Health Care.
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effectivehealthcare.ahrq.gov/sites/default/files/deliberative-methods-facilitation-transcript.pdf
May 29, 2025 - When we’re thinking about passive
participation we’re really thinking about information giving, so that … individuals, and the healthcare system, and thoughts … Or George it’s really important that we hear from everyone, so I’m going to ask you to
hold that thought … Obesity was one of the case studies, and we thought how
do we really ground this, and because we held … So you might begin then to develop thoughts
around making healthy choices, what stops you from making
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psnet.ahrq.gov/node/33656/psn-pdf
September 01, 2007 - In the story you mentioned from the book, the resident thought there was
something wrong with this elderly … But in surgery, our dominant way of thinking still emphasizes individual
conscientiousness. … My thought about it is that if you gave people a choice about whether they'd
like to be learned upon … AG: There is this palpable feel of a difference in results-oriented thinking. … paper or have a conversation with someone, and it opens up a whole new set of ideas
that I hadn't thought
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www.ahrq.gov/hai/cauti-tools/archived-webinars/preventing-cauti-plan-b-transcript.html
December 01, 2017 - There were some areas where we thought a little bit more intensive focus and activity and a little bit … of those events, we also did learn a lot about what is going on in these hospitals in ways that we thought … I wanted to share it with out to elicit your feedback and thoughts because this is another approach that … and Slow where he talks about two systems of thought. … Any final thoughts from our guest presenters today?
Sanjay Singh: This Sanjay.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/preventing-cauti-plan-b-transcript.doc
November 04, 2014 - There were some areas where we thought a little bit more intensive focus and activity and a little bit … of those events, we also did learn a lot about what is going on in these hospitals in ways that we thought … I wanted to share it with out to elicit your feedback and thoughts because this is another approach that … Slow where he talks about two systems of thought. … Any final thoughts from our guest presenters today?
Sanjay Singh:
This Sanjay.
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psnet.ahrq.gov/issue/out-crisis
March 06, 2005 - His thoughts on how to change management thinking in order to achieve success have been applied to the
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www.ahrq.gov/diagnostic-safety/resources/issue-briefs/probabilistic-thinking2.html
September 01, 2022 - impression) is reduced. 11
Understanding the Importance of Language
Clear language reflects organized thinking … aphorisms such as “low threshold” and “diagnosis of exclusion.” 13
Biased language can influence clinical thinking
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www.ahrq.gov/hai/cauti-tools/archived-webinars/assess-adapt-transcript.html
December 01, 2017 - We do not think that—if we thought that creating a checklist or a policy and procedures would instantly … So, if we've thought about creating independent checks and the CLABSI insertion checklist was developed … also say the noise of interruptions, or the noise of multitasking, of the noise of the thousand other thoughts … As I said, given the thoughts about wisdom of crowds, it's crucial to include frontline staff on your … them the opportunity to share what they know, and what they've learned about the care area, and the thoughts
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/assess-adapt-transcript.doc
June 03, 2014 - We do not think that—if we thought that creating a checklist or a policy and procedures would instantly … So, if we’ve thought about creating independent checks and the CLABSI insertion checklist was developed … also say the noise of interruptions, or the noise of multitasking, of the noise of the thousand other thoughts … As I said, given the thoughts about wisdom of crowds, it’s crucial to include frontline staff on your … them the opportunity to share what they know, and what they’ve learned about the care area, and the thoughts
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/education/curriculum-tools/cusptoolkit/modules/understand/scisafety.pptx
March 01, 2009 - express concerns
Gather as many viewpoints as possible
Alternate between convergent and divergent thinking … Divergent thinking occurs on rounds, during brainstorming sessions, and when trying to understand what … might be occurring10
Convergent thinking occurs while formulating a treatment plan or focusing on a
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www.ahrq.gov/patient-safety/settings/labor-delivery/perinatal-care/modules/teamwork/understand-sci-slides.html
July 01, 2023 - Alternate between convergent and divergent thinking 7
Divergent thinking occurs during brainstorming … Convergent thinking occurs while formulating a treatment plan or focusing on a specific task.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/patient-safety-resources/resources/advances-in-patient-safety/vol2/Croskerry.pdf
January 01, 2004 - Ideally, all
information used in diagnostic reasoning is objective and all thinking is logical
and … Two major phenomena that
may undermine objectivity and rational thinking are cognitive dispositions … the day or shift and work through towards the event
• Free-associate fully about the event—recall thoughts … The cognitive imperative: thinking about
how we think. Acad Emerg Med 2000;7:1223–31.
25. … When diagnoses fail: new insights, old
thinking. Can J CME 2003 Nov:51–7.
54. Bonnet MH.
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psnet.ahrq.gov/issue/influence-perceived-difficulty-cases-student-osteopaths-diagnostic-reasoning-cross-sectional
February 03, 2011 - students found that when the case was perceived as more complex, students relied more on analytical thinking … The authors suggest that students receive training to develop intuitive diagnostic thinking.
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www.ahrq.gov/hai/quality/tools/cauti-ltc/modules/resources/tools/cauti-surveillance/pocket-card.html
May 01, 2017 - changes in severity)
Inattention (difficulty focusing and cannot maintain attention)
Disorganized thinking … (thinking is incoherent or hard to follow)
OR
Altered level of consciousness (change is different
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psnet.ahrq.gov/issue/model-patient-how-simulators-are-changing-way-doctors-are-trained
August 24, 2016 - January 14, 2011
Thinking about our thinking as physicians.
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psnet.ahrq.gov/node/42667/psn-pdf
December 30, 2014 - perceptions-safety-culture-vary-across-intensive-care-units-single-institution
https://psnet.ahrq.gov/perspective/establishing-safety-culture-thinking-small … https://psnet.ahrq.gov/perspective/establishing-safety-culture-thinking-small
https://psnet.ahrq.gov