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psnet.ahrq.gov/node/33710/psn-pdf
May 01, 2011 - How much linkage was there in your thinking about this concept of the second
victim and the main theme … AW: I had been thinking about this issue for a few years. … In fact, I began thinking about it when you and I
were RWJ Fellows in San Francisco and I did a study … She meant that she had an incident that she thought she
should tell me about but couldn't bring herself … RW: You mentioned that you thought the no blame approach was somewhat helpful in terms of mitigating
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www.ahrq.gov/prevention/chronic-care/decision/research-centers/achievements.html
December 01, 2014 - A New Model of Thinking in Clinical Preventive Services [ - 390.02 KB] – Center for Excellence in
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psnet.ahrq.gov/perspective/conversation-charles-vincent-mphil-phd
July 10, 2024 - When I first started to think about reporting, like everyone else, I thought about how do you get the … But, if I was thinking about it now, with hindsight, I would start at the other end and I would think … Once you start thinking like that you think, "Well, how many reports do I need?"
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www.ahrq.gov/workingforquality/events/webinar-using-measurement-for-quality-improvement.html
November 01, 2016 - So we can be thinking about patient-centric, outcomes-orientated measures at all three levels. … And so I think that there has not been a systematic, coherent approach to thinking about these things … Rationale for Addressing Measure Proliferation [Slide 7]
Nancy Wilson: So, one of the things that we thought … And money's tight, so we have to really be thinking in a coordinated fashion and in a consensus-based … obviously a lot one can do in this space, but we needed to try to focus on particular areas that we thought
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psnet.ahrq.gov/perspective/conversation-john-d-birkmeyer-md
January 31, 2024 - We'd spent a long time thinking about components of perioperative care—the use of antibiotics, the use … None of the surgeons that agreed to participate in this study went into this study thinking that they … code and realized that they were in some ways staggeringly associated with outcomes, what was your thought … I thought that somehow that there was some tautology or other error associated with how the analysis … I'm thinking about the military or aviation where they have done some aptitude testing before people
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psnet.ahrq.gov/perspective/conversation-eduardo-salas-phd
November 01, 2011 - Eduardo Salas : Well, I thought I would find that health care and medicine in general understand the … Always thinking about what you're thinking. Again, in the military we did that with simulations. … RW : It sounds like it begins with thinking about your own thinking. … RW : I hadn't really thought about this notion that the signal for me to think carefully about this and … We have to start thinking about human–system integration.
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psnet.ahrq.gov/node/60691/psn-pdf
July 15, 2020 - mixed-methods-systematic-review-interventions-address-incivility-nursing
https://psnet.ahrq.gov/issue/systems-thinking-and-incivility-nursing-practice-integrative-review
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psnet.ahrq.gov/node/33641/psn-pdf
November 01, 2006 - concepts of human factors engineering, since these are an
antidote to the "expected complication" way of thinking … psnet.ahrq.gov//#ref3
https://psnet.ahrq.gov//#ref4
https://psnet.ahrq.gov//#ref5
What solutions were you thinking … In the central line case, perhaps you
thought that the nurse should have warned the physician before … Perhaps the
surprise would lead to all kinds of new thinking regarding how to match the design more
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psnet.ahrq.gov/node/33793/psn-pdf
November 01, 2015 - My early thoughts were that the role of research would be to test some of these putative
interventions … RW: How has your thinking evolved in terms of this tension between the just-do-it camp and the we-need … It is possible to marry those two perspectives in
a way that I hadn't thought possible 15 years ago. … Our understanding of IT, thinking about rather than talking about errors so
much, talking about harms … RW: I have residents in our M&M say that "Here's what I thought was going on, but I was worried that
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psnet.ahrq.gov/perspective/getting-patient-safety-personal-story
August 01, 2006 - The ideas of systems thinking and the importance of human factors are now more generally appreciated. … And then, based on that I thought, we have to see if we can prove this in practice. … RW: I imagine that it's hard for people to hold these thoughts in one brainthat it's mostly about systems … Do you worry about it, to some extent, undermining the message about systems thinking? … I just think it's another set of issues to which we must apply similar thinking.
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psnet.ahrq.gov/node/865373/psn-pdf
March 27, 2024 - Sarah Mossburg: I’m thinking back to the point you made earlier: that you can predict who’s at risk, … The clinician is looking at this
patient thinking, “I don’t think so….” … I
remember presenting the algorithm to my clinical mentor and my mentor asked what I thought should … We live in a pretty heterogeneous society, and the diversity of thought
also conveys into the health … Sarah Mossburg: Do you have any thoughts around how models can be validated and monitored to
ensure
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www.ahrq.gov/sites/default/files/wysiwyg/cahps/news-and-events/events/webinars/invitation-messages-transcript.pdf
September 01, 2019 - Our takeaways from the MHQP pilot studies really suggest the importance of thinking carefully about how … I thought that mode
was not yet allowed. Can you clarify please? … Jack, what are your thoughts? And then, Dale, welcome anything you'd care to add. … I welcome further thoughts and observations on this topic. … It's something they thought that their experiences and
having their voice heard could make a difference
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psnet.ahrq.gov/perspective/what-do-we-know-about-emergency-department-safety
June 01, 2010 - I started seeing these repeated thinking errors that very hard-working people were making. … I want to emphasize that I don't think anybody was being casual or sloppy in their thinking. … In the end, I decided to spend my time thinking about how doctors think. … brain of Pat Croskerry when a patient with chest pain comes to see you, versus a physician who hasn't thought … Say what you were thinking; say what you think you were doing wrong.
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psnet.ahrq.gov/node/33857/psn-pdf
July 01, 2012 - My recollection is
that a memo you wrote got people to begin thinking about federal engagement and trying … We were thinking, for example, about what innovative future NIH [National Institutes of Health] grants … have happened without
Meaningful Use requirements because doctors and hospitals just haven't been thinking … I'm going to call out things that did not exist 10 years ago and do now, and I'd love to hear your
thoughts … I
thought if you could do this around the United States, can you imagine how much unnecessary imaging
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psnet.ahrq.gov/node/867696/psn-pdf
March 05, 2025 - importance of understanding failure to
rescue, the patient’s role in care escalation, and systems thinking
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psnet.ahrq.gov/node/866358/psn-pdf
July 24, 2024 - issue/error-medicine
https://psnet.ahrq.gov/issue/does-concept-safety-culture-help-or-hinder-systems-thinking-safety
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psnet.ahrq.gov/perspective/conversation-vineet-arora-md-mapp
May 31, 2023 - I spend a lot of time thinking about my notes, synthesizing the information, distilling it down to the … after we gave out iPads, the percentage of residents who preferred pen and paper to organize their thoughts … If it integrates into your day, you're thinking about a teaching point and you tweet it out at the same … engage patients and providers, the real value is reaching beyond the four walls of your institution—thinking
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psnet.ahrq.gov/perspective/conversation-gregg-s-meyer-md-msc
June 01, 2016 - How have you thought about teaching that and how have you thought about testing that as part of the certification … RW : When you and the other leaders began thinking about patient safety, the American health care system … How does that change the thinking about the content and the methods of both training and certification … Some of our early approaches we thought, "This is a good idea. … The test is comprehensive and requires critical thinking.
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psnet.ahrq.gov/node/33881/psn-pdf
August 01, 2019 - It's also the rate by which technological solutions have been adopted in health care—I'm particularly
thinking … scandal here in Denmark, was that the health care
management purchased a very expensive system and thought … The basic idea is that even when something goes wrong,
people were trying to do what they thought was … You have to spend time now thinking about
what you're going to do later, otherwise you won't be able … I'm still not pessimistic, but what I'm worried about is that people do not spend enough time thinking
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psnet.ahrq.gov/node/855058/psn-pdf
October 31, 2023 - Organizations should be thinking about
staffing, policies around reporting, monitoring, and being alert … Patient safety approaches generally emphasize a “systems”
approach to create safe work environments; thinking … Is that
correct, and what are your thoughts about that?
Cheryl B. … Do you have thoughts about what that might look like?
Cheryl B.