At The Large Multi-Specialty Clinic In Which You Work, There Have Been Two Near Misses And One Medical Error Because Various Clinicians Did Not Follow Up On Patient Results. Different Caregivers Were Involved Each Time. After The Second Near Miss, The Phy (2023)

FAQs

Do you have a safety concern and feel that you must escalate the problem in this context escalation means? ›

You have a safety concern and feel that you must escalate the problem. In this context, "escalation" means: Communicating the problem, including when and where it is occurring, to the person who has the span of authority to fix system flaws.

A nurse who realized that his colleagues weren't consistently following up on patient results reported the problem to the clinic leadership right away. Which response would be most consistent with a culture of safety? The best answer is investigating the problem and seeking systems solutions.

Which of the following types of errors is associated with automatic thinking? Rationale: Automatic thinking is rapid, effortless thought, during which we are vulnerable to what experts call skill-based errors, which include errors of execution or memory storage.

Staff may view the punishment as unfair, and worry that they will be punished if they make an error. This fear decreases the chances of staff reporting errors so that the system can learn from them. Staff trying to be more careful will ultimately not eliminate errors caused by faulty systems.

Aside from the risk to patient safety, there are other consequences of poor communication. Patients often experience long delays, often at several stages of their journey in a hospital. Many of the delays are the result of poor communication between staff.

Through its receptors, the nervous system keeps us in touch with our environment, both external and internal.

Clear definition - HRO Safety Culture

Professional leadership attitudes in a High Reliability Organization that manage potentially hazardous activities to maintain risk to people and the environment as low as reasonably achievable, thereby assuring stakeholder trust.

Cooperation. Safety works best if management and workers feel like they are on the same team. Cooperation means working together to develop a strong safety program (e.g., management involving line workers in creating safety policies and procedures).

Who can play an important role in safer more effective prescribing? ›

Ensuring the safe prescribing and dispensing of medication to patients is a core function of a pharmacist. Pharmacists ensure that patients not only get the correct medication and dosing, but that they have the guidance they need to use the medication safely and effectively.

Human factors such as fatigue, stress, and poor communication can all increase the risk of human error occurring.

Communication breakdowns are the most common causes of medical errors. Whether verbal or written, these issues can arise in a medical practice or a healthcare system and can occur between a physician, nurse, healthcare team member, or patient. Poor communication often results in medical errors.

A Just Culture identifies 3 types of behavioral choices: human error, at-risk behavior, and reckless behavior. It establishes a fair and transparent process for evaluating errors and determining a course of action based on the quality of the behavior and not on the outcome of the error.

Unintended adverse consequences (UACs) fell into nine major categories (in order of decreasing frequency): 1) more/new work for clinicians; 2) unfavorable workflow issues; 3) never ending system demands; 4) problems related to paper persistence; 5) untoward changes in communication patterns and practices; 6) negative ...

Your immediate supervisor should be the very first person you address safety concerns with, even if you have a company safety director. Give them the opportunity to fix the problem. If you do approach them and their response is simply unsatisfactory, then you may need to seek help elsewhere.

Escalating an issue means taking action to improve the situation by bringing attention to it and/or involving additional resources. There are many ways to escalate an issue, but the most important thing is to be clear about what you want to achieve and who you need to involve in order to make progress.

Once residents recognize a sick or deteriorating patient, a skill that is learned throughout training, they are then expected to communicate their concerns to senior team members such as fellows or attending physicians as part of a process known as care escalation.