PPT-Learning From Defects Through Sensemaking

Author : min-jolicoeur | Published Date : 2018-10-31

AHRQ Safety Program for Surgery Implementation AHRQ Pub No 1618000415EF December 2017 Learning Objectives Describe difference between firstorder and secondorder

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Learning From Defects Through Sensemaking: Transcript

AHRQ Safety Program for Surgery Implementation AHRQ Pub No 1618000415EF December 2017 Learning Objectives Describe difference between firstorder and secondorder problem solving List contributing factors that make defects in care more likely to occur. In the United States about 7200 or 18 per 10000 babies born every year have critical congenital heart defects CCHDs which also are known collectively in some instances as critical congenital heart disease These CCHDs are coarctation of the aorta do Review the impact of errors and patient harm and the underlying causes of errors. Show how CUSP supports other quality and safety tools . Describe Comprehensive Unit-based Safety Program (CUSP) framework and the goals of the . Review . key steps of the CUSP Toolkit. Learn how Just Culture principles can augment CUSP. 2. Introduce Just Culture principles . Introduction to Just Culture Principles. 3. Understand Just Culture. Hemodynamics, Pharmacology, and Updates. Amanda L. Affleck CRNA, MAE. Providence Anesthesia Services. Five Basic Questions. Is the patient acyanotic or cyanotic?. Is pulmonary arterial blood flow increased or not?. Sensemaking. Tools. 1. CUSP Tools. Sensemaking. Tools. Staff Safety Assessment. Discovery Form. Safety Issues Worksheet. Root Cause Analysis. Learn from Defects Form. Failure Mode and Effects Analysis. Introduce the three basic types of imperfections: point defects, line defects (or dislocations), and surface defects.. Explore the nature and effects of different types of defects.. 2. Point defects. Two Examples on . 2016 Presidential Election. Or This. http://. www.nytimes.com/interactive/2016/11/08/us/elections/how-trump-pushed-the-election-map-to-the-right.html. Are They Good Enough to Analyze What Was Going On?. By the end of this presentation participants will be able to. Describe . clinical features of . gastroschisis. Understand . main . epidemiological . features of . gastroschisis. Apply helpful . tips for coding and . Show how CUSP supports other quality and safety tools . Describe Comprehensive Unit-based Safety Program (CUSP) framework and the goals of the . CUSP Toolkit. Demonstrate how to apply the . CUSP Toolkit . AHRQ Safety Program for . Surgery. Sustainability. AHRQ Pub. No. 16(18)-0004-15-EF. December 2017. Learning . Objectives. After this session, you will be able to–. Describe the difference between first-order and second-order problem solving. key steps of the CUSP Toolkit. Learn how Just Culture principles can augment CUSP. 2. Introduce Just Culture principles . Introduction to Just Culture Principles. 3. Understand Just Culture. 4. Just Culture. . AHRQ Safety Program for Improving Antibiotic Use. Presenter – Pranita Tamma. Pranita D. Tamma, MD, MHS. Title: . Assistant Professor of Pediatrics; Director of the Pediatric Antimicrobial Stewardship Program. Sensemaking and Learn From Defects for Perinatal Safety. AHRQ Publication No. 17-0003-5-EF. May 2017. Learning Objectives. 2. AHRQ Safety Program for Perinatal Care. CUSP and Sensemaking Tools. 1. CUSP Tools. H. eating, ion bombardment and contacts. Richard J. . Cobley. *. , Chris J. Barnett, Olga . Kryvchenkova. , Nathan A. Smith, Karol . Kalna. , Thierry G. G. Maffeis. . M. . N. . C. . Multidisciplinary.

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