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AHRQ Research Studies Date
Topics
- Adverse Events (8)
- Care Coordination (1)
- Central Line-Associated Bloodstream Infections (CLABSI) (1)
- Children/Adolescents (1)
- Communication (4)
- Comprehensive Unit-based Safety Program (CUSP) (2)
- Critical Care (2)
- Elderly (1)
- Electronic Health Records (EHRs) (2)
- Evidence-Based Practice (1)
- Falls (2)
- Guidelines (1)
- Healthcare-Associated Infections (HAIs) (2)
- Healthcare Delivery (2)
- Health Services Research (HSR) (1)
- Hospitals (7)
- Implementation (1)
- Inpatient Care (4)
- Intensive Care Unit (ICU) (4)
- Labor and Delivery (2)
- Maternal Care (1)
- Medical Errors (2)
- Mortality (1)
- Neonatal Intensive Care Unit (NICU) (1)
- Newborns/Infants (3)
- Nursing (1)
- Organizational Change (1)
- Outcomes (2)
- Patient-Centered Healthcare (1)
- Patient-Centered Outcomes Research (1)
- Patient and Family Engagement (1)
- (-) Patient Safety (27)
- Pregnancy (2)
- Prevention (3)
- Primary Care (2)
- Provider (3)
- Provider: Clinician (1)
- Provider: Health Personnel (1)
- Provider: Nurse (2)
- Provider: Physician (2)
- Provider Performance (2)
- Quality Improvement (5)
- Quality of Care (6)
- Rural Health (1)
- Shared Decision Making (2)
- Simulation (1)
- Surgery (3)
- Surveys on Patient Safety Culture (2)
- (-) Teams (27)
- TeamSTEPPS (4)
- Tools & Toolkits (1)
- Training (3)
- Trauma (1)
- Women (1)
- Young Adults (1)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 27 Research Studies DisplayedAtkinson MK, Benneyan JC, Bambury EA
Evaluating a patient safety learning laboratory to create an interdisciplinary ecosystem for health care innovation.
A patient safety learning laboratory (lab) can be a critical element of nurturing interdisciplinary team innovation across multiple projects and organizations. The purpose of this mixed-methods study was to evaluate a patient safety learning lab to examine the role and activities of a learning ecosystem that support interdisciplinary team innovation. The study found that successful learning ecosystems continuously facilitate alignment between interdisciplinary teams' activities, organizational context, and innovation project objectives. The researchers concluded that Interdisciplinary learning ecosystems have the capacity to facilitate health care improvement and innovation through alignment of team activities, project goals, and organizational contexts.
AHRQ-funded; HS024453.
Citation: Atkinson MK, Benneyan JC, Bambury EA .
Evaluating a patient safety learning laboratory to create an interdisciplinary ecosystem for health care innovation.
Health Care Manage Rev 2022 Jul-Sep;47(3):E50-E61. doi: 10.1097/hmr.0000000000000330..
Keywords: Patient Safety, Teams, Healthcare Delivery
Baloh J, Zhu X, Ward MM
What influences sustainment and nonsustainment of facilitation activities in implementation? Analysis of organizational factors in hospitals implementing TeamSTEPPS.
This study looked at the influences on sustainment of internal facilitation activities. For two years the authors followed 10 small rural hospitals implementing TeamSTEPPS, a patient safety program. Factors the authors examined were the influence of senior management support (SMS), middle management support (MMS), facilitator team time availability (TIME), and team continuity (CONTINUITY). Five hospitals sustained facilitation activities and they found that the combination of SMS, MMS, and CONTINUITY was a sufficient condition for sustainment. The five other hospitals that did not sustain facilitation activities either lacked MMS or lacked both TIME and CONTINUITY. They also discussed the implications for research and practice.
AHRQ-funded; HS024112; HS018396.
Citation: Baloh J, Zhu X, Ward MM .
What influences sustainment and nonsustainment of facilitation activities in implementation? Analysis of organizational factors in hospitals implementing TeamSTEPPS.
Med Care Res Rev 2021 Apr;78(2):146-56. doi: 10.1177/1077558719848267..
Keywords: TeamSTEPPS, Teams, Implementation, Hospitals, Patient Safety, Rural Health, Organizational Change
O'Leary KJ, Manojlovich M, Johnson JK
A multisite study of interprofessional teamwork and collaboration on general medical services.
This multisite study of four mid-sized hospitals measured teamwork climate of nurses, nurse assistants, and physicians working on general medical services. Teamwork climate scores for 380 participants (80 hospitalists, 13 resident physicians, 193 nurses, and 94 nurses) were measured using the Safety Attitudes Questionnaire. Hospitalists had the highest median teamwork climate score and nurses had the lowest, but it was not a statistically significant difference. A higher percentage of hospitalists (63.3%) rated the quality of collaboration with nurses as high or very high, but only 48.7% of nurses rated the collaboration with hospitalists as high or very high. There were significant differences in perceptions of teamwork climate across sites and across professional categories.
AHRQ-funded; HS025649.
Citation: O'Leary KJ, Manojlovich M, Johnson JK .
A multisite study of interprofessional teamwork and collaboration on general medical services.
Jt Comm J Qual Patient Saf 2020 Dec;46(12):667-72. doi: 10.1016/j.jcjq.2020.09.009..
Keywords: Teams, Hospitals, Patient Safety, Provider: Clinician, Provider: Physician, Provider: Nurse, Provider
Costar DM, Hall KK
Improving team performance and patient safety on the job through team training and performance support tools: a systematic review.
This systematic review’s objective was to identify recent studies that implemented practices to improve teamwork in health care and were associated with positive improvements on the job. Two databases were searched to identify relevant articles published between 2008 and 2018. Twenty articles were selected for inclusion. Across studies, measures assessing teamwork skills on the job were most often collected and sustained improvements were shown for up to 12 months. Evidence of improved clinical practices and increased patient safety was found in both studies team training interventions, as well as those that introduced performance support tools. All studies were conducted in hospitals with very few studies found in other health care settings such as office-based care.
AHRQ-funded; HHSP233201500013I.
Citation: Costar DM, Hall KK .
Improving team performance and patient safety on the job through team training and performance support tools: a systematic review.
J Patient Saf 2020 Sep;16(3S Suppl 1):S48-s56. doi: 10.1097/pts.0000000000000746..
Keywords: Teams, Patient Safety, Training, Patient Safety, Provider Performance, Quality Improvement, Quality of Care
Lai AY, Yuan CT, Marsteller JA
Patient safety in primary care: conceptual meanings to the health care team and patients.
This study’s goal was to describe how frontline clinicians, administrators, and staff conceptualize patient safety in primary care and to compare and contrast these conceptual meanings from the patient's perspective. Findings indicated that frontline personnel conceptualized patient safety in terms of work functions; frontline personnel and patients conceptualized patient safety in largely consistent ways.
Citation: Lai AY, Yuan CT, Marsteller JA .
Patient safety in primary care: conceptual meanings to the health care team and patients.
J Am Board Fam Med 2020 Sep-Oct;33(5):754-64. doi: 10.3122/jabfm.2020.05.200042..
Keywords: Primary Care, Patient Safety, Teams
Krein SL, Kuhn L, Ratz D
Use of designated nurse PICC teams and CLABSI prevention practices among U.S. hospitals: a survey-based study.
The authors identified the prevalence of and factors associated with having a designated nurse peripherally inserted central catheter (PICC) team among U.S. acute care hospitals. They found that nurse PICC teams inserted PICCs in more than 60% of U.S. hospitals during the study period. Moreover, certain practices to prevent central line-associated bloodstream infection, including maximum sterile barrier precautions, chlorhexidine gluconate for insertion site antisepsis, and facility-wide insertion checklists were regularly used by a higher percentage of hospitals with nurse PICC teams compared with those without. They concluded that nurse PICC teams play an integral role in PICC use at many hospitals and that use of such teams may promote key practices to prevent complications.
AHRQ-funded; HS022835.
Citation: Krein SL, Kuhn L, Ratz D .
Use of designated nurse PICC teams and CLABSI prevention practices among U.S. hospitals: a survey-based study.
J Patient Saf 2019 Dec;15(4):293-95. doi: 10.1097/pts.0000000000000246..
Keywords: Nursing, Teams, Central Line-Associated Bloodstream Infections (CLABSI), Healthcare-Associated Infections (HAIs), Inpatient Care, Hospitals, Patient Safety, Prevention, Provider: Nurse, Provider
Jones KJ, Crowe J, Allen JA
The impact of post-fall huddles on repeat fall rates and perceptions of safety culture: a quasi-experimental evaluation of a patient safety demonstration project.
The purpose of this study was to determine associations between conducting post-fall huddles and repeat fall rates and between post-fall huddle participation and perceptions of teamwork and safety culture. The investigators concluded that post-fall huddles may reduce the risk of repeat falls. Staff who participate in post-fall huddles were likely to have positive perceptions of teamwork support for fall-risk reduction and safety culture because huddles are a team-based approach to reporting, adapting, and learning.
AHRQ-funded; HS024630; HS021429.
Citation: Jones KJ, Crowe J, Allen JA .
The impact of post-fall huddles on repeat fall rates and perceptions of safety culture: a quasi-experimental evaluation of a patient safety demonstration project.
BMC Health Serv Res 2019 Sep 9;19(1):650. doi: 10.1186/s12913-019-4453-y..
Keywords: TeamSTEPPS, Falls, Adverse Events, Surveys on Patient Safety Culture, Patient Safety, Hospitals, Teams
Wooldridge A, Carayon P, Hoonakker P
Complexity of the pediatric trauma care process: implications for multi-level awareness.
Trauma is the leading cause of disability and death in children and young adults in the US. While much is known about the medical aspects of inpatient pediatric trauma care, not much is known about the processes and roles involved in in-hospital care. Using human factors engineering (HFE) methods, the investigators combined interview, archival document and trauma registry data to describe how intra-hospital care transitions affect process and team complexity.
AHRQ-funded; HS023837.
Citation: Wooldridge A, Carayon P, Hoonakker P .
Complexity of the pediatric trauma care process: implications for multi-level awareness.
Cogn Technol Work 2019 Aug;21(3):397-416. doi: 10.1007/s10111-018-0520-0..
Keywords: Care Coordination, Children/Adolescents, Critical Care, Health Services Research (HSR), Healthcare Delivery, Inpatient Care, Patient Safety, Teams, Trauma, Young Adults
Kahwati LC, Sorensen AV, Teixeira-Poit S
AHRQ Author: Mistry KB
Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care.
The purpose of this study was to describe the Safety Program for Perinatal Care (SPPC) implementation experience and evaluate the short-term impact on labor and delivery (L&D) unit patient safety culture, processes, and adverse events. SPPC implementation by L&D units were supported sing a program toolkit, trainings, and technical assistance. Researchers then evaluated the program using a pre-post, mixed-methods design. Changes in safety and quality were measured using the Modified Adverse Outcome Index (MAOI) and other perinatal care indicators. Findings showed that SPPC had a favorable impact on unit patient safety culture and processes, but mixed short-term impact on maternal and neonatal adverse events.
AHRQ-authored; AHRQ-funded; 2902010000241.
Citation: Kahwati LC, Sorensen AV, Teixeira-Poit S .
Impact of the Agency for Healthcare Research and Quality's Safety Program for Perinatal Care.
Jt Comm J Qual Patient Saf 2019 Apr;45(4):231-40. doi: 10.1016/j.jcjq.2018.11.002..
Keywords: Adverse Events, Communication, Comprehensive Unit-based Safety Program (CUSP), Labor and Delivery, Maternal Care, Newborns/Infants, Outcomes, Patient Safety, Pregnancy, Simulation, Surveys on Patient Safety Culture, Teams, TeamSTEPPS, Training, Women
Frasier LL, Pavuluri Quamme SR, Ma Y
Familiarity and communication in the operating room.
Researchers sought to evaluate the relationship between familiarity, communication rates, and communication ineffectiveness of health care providers in the operating room. They found that team members do not compensate for unfamiliarity by increasing their verbal communication, and dyad familiarity is not protective against ineffective communication. Cross-disciplinary communication remains vulnerable in the operating room, suggesting poor crosstalk across disciplines in the operative setting. They recommended further investigation to explore these relationships and identify effective interventions, ensuring that all team members have the necessary information to optimize their performance.
AHRQ-funded; HS022403.
Citation: Frasier LL, Pavuluri Quamme SR, Ma Y .
Familiarity and communication in the operating room.
J Surg Res 2019 Mar;235:395-403. doi: 10.1016/j.jss.2018.09.079..
Keywords: Communication, Patient Safety, Surgery, Teams, Provider: Physician, Provider
Bordley J, Sakata KK, Bierman J
Use of a novel, electronic health record-centered, interprofessional ICU rounding simulation to understand latent safety issues.
The electronic health record is a primary source of information for all professional groups participating in ICU rounds. However, it is unclear how team dynamics impacts identification and verbalization of viewed data. Therefore, the investigators created an ICU rounding simulation to assess how the interprofessional team recognized and reported data and its impact on decision-making.
AHRQ-funded; HS023793.
Citation: Bordley J, Sakata KK, Bierman J .
Use of a novel, electronic health record-centered, interprofessional ICU rounding simulation to understand latent safety issues.
Crit Care Med 2018 Oct;46(10):1570-76. doi: 10.1097/ccm.0000000000003302..
Keywords: Shared Decision Making, Electronic Health Records (EHRs), Intensive Care Unit (ICU), Patient Safety, Teams
Reiter-Palmon R, Kennel V, Allen J
Good catch! Using interdisciplinary teams and team reflexivity to improve patient safety.
This article considers the role of reflexivity in team innovation implementation and its association with inpatient fall rates. The study it describes examined 16 small rural hospitals in which interdisciplinary teams intended to decrease fall risk were implemented, supported, and evaluated. Team reflexivity was assessed at the start and at the end of the 2-year intervention, and innovation implementation assessed at the end of the intervention. The hospitals reported objective fall event data and patient days throughout the project. Both the theoretical and practical applications of the results are discussed.
AHRQ-funded; HS021429; HS024630.
Citation: Reiter-Palmon R, Kennel V, Allen J .
Good catch! Using interdisciplinary teams and team reflexivity to improve patient safety.
Group & Organization Management 2018 Jun;43(3):414-39. doi: 10.1177/1059601118768163..
Keywords: Teams, Patient Safety, Falls, Prevention, Hospitals, Adverse Events
Bordley J, Sakata KK, Bierman J
Medication history versus point-of-care platelet activity testing in patients with intracerebral hemorrhage.
This study evaluated whether reduced platelet activity detected by point-of-care (POC) testing was a better predictor of hematoma expansion and poor functional outcomes in patients with intracerebral hemorrhage (ICH) than a history of antiplatelet medication exposure. A history of antiplatelet medication use better identified patients at risk for hematoma growth and poor functional outcomes than POC measures of platelet activity after spontaneous ICH.
AHRQ-funded; HS023793.
Citation: Bordley J, Sakata KK, Bierman J .
Medication history versus point-of-care platelet activity testing in patients with intracerebral hemorrhage.
Crit Care Med 2018 Oct;46(10):1570-76. doi: 10.1097/ccm.0000000000003302..
Keywords: Shared Decision Making, Electronic Health Records (EHRs), Intensive Care Unit (ICU), Patient Safety, Teams
Costa DK, Valley TS, Miller MA
AHRQ Author: Miller MA
ICU team composition and its association with ABCDE implementation in a quality collaborative.
Awakening, Breathing Coordination, Delirium, and Early Mobility bundle (ABCDE) should involve an interprofessional team, yet no studies describe what team composition supports implementation. This study found that ABCDE implementation was associated with frequent involvement of team members, suggesting a need for role articulation and coordination.
AHRQ-authored; AHRQ-funded; HS024552.
Citation: Costa DK, Valley TS, Miller MA .
ICU team composition and its association with ABCDE implementation in a quality collaborative.
J Crit Care 2018 Apr;44:1-6. doi: 10.1016/j.jcrc.2017.09.180.
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Keywords: Critical Care, Intensive Care Unit (ICU), Patient Safety, Quality Improvement, Teams
Fernandez R, Shah S, Rosenman ED
Developing team cognition: a role for simulation.
Evidence from team science research demonstrates a strong relationship between team cognition and team performance and suggests a role for simulation in the development of this team-level construct. In this article, the researchers synthesize research from the broader team science literature to provide foundational knowledge regarding team cognition and highlight best practices for using simulation to target team cognition.
AHRQ-funded; HS020295; HS022458.
Citation: Fernandez R, Shah S, Rosenman ED .
Developing team cognition: a role for simulation.
Simul Healthc 2017 Apr;12(2):96-103. doi: 10.1097/sih.0000000000000200.
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Keywords: Teams, Training, Provider Performance, Patient Safety
Burstein PD, Zalenski DM, Edwards JL
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
The researchers established a multifactorial shoulder dystocia response and management protocol to promote sustainable practice change. In the first year, there was a threefold increase in shoulder dystocia reporting, which continued in years 2 and 3. In the first year, 96 percent of clinicians completed all training elements. Overall teams reached a 99 percent adoption rate of the shoulder dystocia protocol.
AHRQ-funded; HS019608.
Citation: Burstein PD, Zalenski DM, Edwards JL .
Changing labor and delivery practice: focus on achieving practice and documentation standardization with the goal of improving neonatal outcomes.
Health Serv Res 2016 Dec;51 Suppl 3:2472-86. doi: 10.1111/1475-6773.12589.
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Keywords: Labor and Delivery, Newborns/Infants, Adverse Events, Quality Improvement, Quality of Care, Patient Safety, Patient-Centered Outcomes Research, Outcomes, Guidelines, Evidence-Based Practice, Pregnancy, Teams
Profit J, Lee HC, Sharek PJ
Comparing NICU teamwork and safety climate across two commonly used survey instruments.
The objectives of this study were to assess variation in safety and teamwork climate and in the neonatal intensive care unit (NICU) setting, and compare measurement of safety culture scales using two different instruments (Safety Attitudes Questionnaire (SAQ) and Hospital Survey on Patient Safety Culture (HSOPSC)). It concluded that large variation and opportunities for improvement in patient safety culture exist across NICUs. Important systematic differences exist between SAQ and HSOPSC.
AHRQ-funded; HS014246.
Citation: Profit J, Lee HC, Sharek PJ .
Comparing NICU teamwork and safety climate across two commonly used survey instruments.
BMJ Qual Saf 2016 Dec;25(12):954-61. doi: 10.1136/bmjqs-2014-003924.
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Keywords: Hospitals, Intensive Care Unit (ICU), Neonatal Intensive Care Unit (NICU), Newborns/Infants, Patient Safety, Teams
Mueller SK, Schnipper JL, Giannelli K
Impact of regionalized care on concordance of plan and preventable adverse events on general medicine services.
This study regionalized 3 inpatient general medical teams to nursing units and examined the association with communication and preventable adverse events (AEs). It found that regionalization of care teams improved recognition of care team members, discussion of daily care plan, and agreement on estimated discharge date, but did not significantly improve nurse and physician concordance of the care plan or reduce the odds of preventable AEs.
AHRQ-funded; HS023331.
Citation: Mueller SK, Schnipper JL, Giannelli K .
Impact of regionalized care on concordance of plan and preventable adverse events on general medicine services.
J Hosp Med 2016 Sep;11(9):620-7. doi: 10.1002/jhm.2566.
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Keywords: Adverse Events, Communication, Hospitals, Patient Safety, Teams
Fiscella K, Fogarty C, Salas E
What can primary care learn from sports teams?
The authors used sports teams to illustrate key principles from team science and to extract practical lessons for primary care teams.
AHRQ-funded; HS022440.
Citation: Fiscella K, Fogarty C, Salas E .
What can primary care learn from sports teams?
J Ambul Care Manage 2016 Jul-Sep;39(3):279-85. doi: 10.1097/jac.0000000000000120.
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Keywords: Patient Safety, Primary Care, Quality Improvement, Teams
Ghaferi AA, Dimick JB
Importance of teamwork, communication and culture on failure-to-rescue in the elderly.
The researchers reviewed the literature evaluating surgery, mortality, failure-to-rescue and the elderly. This was followed by a review of ongoing studies and unpublished work aiming to understand better the mechanisms underlying variations in surgical mortality in elderly patients. They concluded that although elderly surgical patients experienced failure-to-rescue events at much higher rates than their younger counterparts, patient-level effects did not sufficiently explain these differences.
AHRQ-funded; HS023621; HS024403; HS023597.
Citation: Ghaferi AA, Dimick JB .
Importance of teamwork, communication and culture on failure-to-rescue in the elderly.
Br J Surg 2016 Jan;103(2):e47-51. doi: 10.1002/bjs.10031.
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Keywords: Elderly, Mortality, Surgery, Teams, Patient Safety
Etchegaray JM, Thomas EJ
Engaging employees: the importance of high-performance work systems for patient safety.
The researchers developed and tested survey items that measure high-performance work systems (HPWSs), reported psychometric characteristics of the survey, and examined associations between HPWSs and teamwork culture, safety culture, and overall patient safety grade. They concluded that the HPWSs survey was reliable, distinct from safety culture and teamwork culture based on a confirmatory factor analysis.
AHRQ-funded; HS017145.
Citation: Etchegaray JM, Thomas EJ .
Engaging employees: the importance of high-performance work systems for patient safety.
J Patient Saf 2015 Dec;11(4):221-7. doi: 10.1097/pts.0000000000000076.
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Keywords: Patient Safety, Quality of Care, Teams
Fernandez R, Grand JA
Leveraging social science-healthcare collaborations to improve teamwork and patient safety.
This article highlights guiding team science principles from the organizational psychology literature that can be applied to the study of teams in healthcare. The authors' goal is to provide some common language and understanding around teams and teamwork. Additionally, they hope to impart an appreciation for the potential synergy present within clinician-social scientist collaborations.
AHRQ-funded; HS020295; HS022458.
Citation: Fernandez R, Grand JA .
Leveraging social science-healthcare collaborations to improve teamwork and patient safety.
Curr Probl Pediatr Adolesc Health Care 2015 Dec;45(12):370-7. doi: 10.1016/j.cppeds.2015.10.005.
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Keywords: Patient Safety, Teams, Quality Improvement, Quality of Care, Medical Errors, Adverse Events
Dykes PC, Stade D, Dalal A
Strategies for managing mobile devices for use by hospitalized inpatients.
The authors implemented the PROSPECT (Promoting Respect and Ongoing Safety through Patient-centeredness, Engagement, Communication and Technology) project at Brigham and Women's Hospital. The goal of PROSPECT is to transform the hospital environment by providing a suite of e-tools to facilitate teamwork. In this paper, the authors described decisions and challenges faced and related the strategies used and lessons learned.
AHRQ-funded; HS023535.
Citation: Dykes PC, Stade D, Dalal A .
Strategies for managing mobile devices for use by hospitalized inpatients.
AMIA Annu Symp Proc 2015 Nov 5;2015:522-31.
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Keywords: Communication, Inpatient Care, Patient and Family Engagement, Patient Safety, Teams
O'Leary KJ, Creden AJ, Slade ME
Implementation of unit-based interventions to improve teamwork and patient safety on a medical service.
The authors compared a pre- versus post-intervention on Structured Interdisciplinary Rounds (SIDRs). They found that paired analyses for 82 professionals completing surveys revealed improved teamwork, which was driven mainly by nurses, and that the adverse events rate was similar across study periods; however, SIDR did not reduce adverse events.
AHRQ-funded; HS019630.
Citation: O'Leary KJ, Creden AJ, Slade ME .
Implementation of unit-based interventions to improve teamwork and patient safety on a medical service.
Am J Med Qual 2015 Sep-Oct;30(5):409-16. doi: 10.1177/1062860614538093.
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Keywords: Adverse Events, Provider: Health Personnel, Inpatient Care, Patient Safety, Teams
Brady PJ, Battles JB, Ricciardi R
AHRQ Author: Brady PJ, Battles JB, Ricciardi R
Teamwork: what health care has learned from the military.
Health care depends on clear instructions and relies not just on individuals but also on strong teams. The authors point out that well-functioning teams make fewer mistakes than do individuals. They describe how military principles can be applied to healthcare, including the elements of structure, accountability, and patient-centeredness.
AHRQ-authored.
Citation: Brady PJ, Battles JB, Ricciardi R .
Teamwork: what health care has learned from the military.
J Nurs Care Qual 2015 Jan-Mar;30(1):3-6. doi: 10.1097/ncq.0000000000000094.
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Keywords: TeamSTEPPS, Teams, Patient-Centered Healthcare, Patient Safety, Quality of Care