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psnet.ahrq.gov/issue/improving-team-members-attention-during-or-briefing-or-time-out
November 10, 2021 - 2023
Provider-patient communication and hospital ratings: perceived gaps and forward thinking
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psnet.ahrq.gov/issue/frequency-medication-administration-timing-error-hospitals-systematic-review
March 15, 2023 - March 29, 2023
Toward the translation of systems thinking methods in patient safety practice
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psnet.ahrq.gov/issue/good-and-bad-reasons-swiss-cheese-model-and-its-critics
September 14, 2022 - Towards a unified model of accident causation: refining and validating the systems thinking
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psnet.ahrq.gov/perspective/patient-safety-and-health-information-technology-learning-our-mistakes
July 01, 2012 - RW : Did the unintended consequences literature influence your thinking about it? … Who would have thought 10 years ago that the iPad would be available to help with electronic health records … I was thinking that you might go on to ask, why would the patient actually need to go in and see the … I figured that IT was a pretty benign, white hat kind of thing, but not everyone thought that way.
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psnet.ahrq.gov/perspective/conversation-pascale-carayon-phd-and-nicole-werner-phd
November 16, 2022 - [computerized provider order entry], or the medication administration, or whatever, without really thinking … We’re thinking about this time point as an opportunity to actually improve safety rather than thinking … Again, thinking about the feedback loop.
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www.ahrq.gov/sites/default/files/wysiwyg/hai/tools/perinatal-care-2/hypertension_4-situation-monitoring-speaker-notes.pdf
July 01, 2023 - Smith’s initial presentation to L&D triage, I thought Beth did well
by identifying her severe‐range … Smith, but I
thought everyone
did a great job and
Ms. … She actively invites
thoughts from Ms. … Smith’s bedside nurse, Beth, a quieter teammate, who hasn’t yet
contributed her thoughts. … Johnson encouraged independent thought, inclusion, and prompted discussion of both
opportunities for
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psnet.ahrq.gov/issue/patient-safety-synergy-technology-and-behavior
February 18, 2015 - June 23, 2010
Preventing catheter-related bloodstream infections: thinking outside the
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psnet.ahrq.gov/issue/interactions-between-context-health-care-organisation-and-failure-situational-impact-failure
May 17, 2012 - August 15, 2018
A concept analysis of systems thinking.
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www.ahrq.gov/hai/cusp/toolkit/content-calls/assertion-slides/assertion-slides.html
October 01, 2014 - You are uninformed”
Often expression of feelings, thoughts in a way that is not wholly truthful
Usually … Fail to express your thoughts or opinions
Sarcastic
Give in with resentment
Remain silent
Body … Assertion IS
Being appropriately assertive means:
Organized in thought and communication
Speak
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digital.ahrq.gov/sites/default/files/docs/workflowtoolkit/Electronic_medical_record_checklist.pdf
December 18, 2021 - 104 Inverness Terrace East
Englewood, CO 80112
Electronic Medical Record (EMR) checklist
Thinking
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psnet.ahrq.gov/perspective/using-human-factors-engineering-and-seips-model-advance-patient-safety-care-transitions
November 16, 2022 - [computerized provider order entry], or the medication administration, or whatever, without really thinking … We’re thinking about this time point as an opportunity to actually improve safety rather than thinking … Again, thinking about the feedback loop.
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www.ahrq.gov/teamstepps-program/curriculum/implement/teach.html
January 01, 2024 - The individual matched with a team will be able to gather thoughts from the exercise that can be generalized
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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/6_TK1_T6-Managing_Resident_and_Family_Expectations_Final.pdf
October 01, 2016 - Have you ever had an experience where someone requested an
antibiotic for what they thought was a UTI … Any other thoughts about these talking points?
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www.ahrq.gov/sites/default/files/wysiwyg/nhguide/6_TK1_T6-Managing_Resident_and_Family_Expectations_Final.docx
October 01, 2016 - Have you ever had an experience where someone requested an antibiotic for what they thought was a UTI … Any other thoughts about these talking points?
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psnet.ahrq.gov/issue/misuse-abuse-and-medication-errors-adverse-events-associated-opioids-systematic-review
January 15, 2025 - Patient safety in palliative care at the end of life from the perspective of complex thinking
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psnet.ahrq.gov/perspective/conversation-j-bryan-sexton-phd-ma
February 26, 2025 - We interviewed him in 2006 about safety culture for AHRQ WebM&M and thought it was time to check in on … how his thinking and research has evolved.
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www.ahrq.gov/hai/cauti-tools/archived-webinars/no-more-cauti-transcript.html
December 01, 2017 - Just some additional thoughts, and before I forget, some people do ask some questions about the simulation … Just to wrap up, a couple of additional thoughts.
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www.ahrq.gov/sites/default/files/wysiwyg/professionals/quality-patient-safety/hais/cauti-tools/archived-webinars/No_More_CAUTI_Preventing_CAUTI_transcript.docx
May 05, 2015 - Just some additional thoughts, and before I forget, some people do ask some questions about the simulation … Just to wrap up, a couple of additional thoughts.
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www.ahrq.gov/hai/cauti-tools/archived-webinars/no-more-cauti-preventing-cauti-transcript.html
November 01, 2015 - Just some additional thoughts, and before I forget, some people do ask some questions about the simulation … Just to wrap up, a couple of additional thoughts.
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psnet.ahrq.gov/perspective/diagnostic-errors
December 01, 2013 - the augmentation of performance that occurs when clinicians shift from automatic to more reflective thinking … highlighted the increased diagnostic accuracy that comes from shifting out of the fast, intuitive mode of thinking … Summary
Taken together, the literature published in 2014 represents a significant advance in our thinking … I am always thinking about what's next and how are we going to support future research. … was an opportunity to write a first author paper on a related topic, I would take it if my mentors thought