Updated: 12/29/2021

Quality and Safety

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  • Human Factors Design
    • Forcing function
      • a method to prevent undesirable results by forcing the optimal choice as default
        • e.g., setting a default prescription length for medications that are prone to abuse
      • this is the most effective intervention in human factor design
    • Standardization
      • a method to increase process reliability
        • e.g., having a checklist
    • Simplification
      • a method to decrease wasteful activities
        • electronic medical record consolidation
  • Safety Culture
    • A safe environment where people can express their safety concerns without fear of negative consequences
    • Use systems-based methods when able to prevent errors
  • PDSA cycle
    • A method to test change in the clinical setting
      • Plan
        • define what is the problem and the desired solution
      • Do
        • test the new process
      • Study
        • measure and analyze the data generated
      • Act
        • integration
      • mnemonic: "PDSA"
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(M2.OMB.1) A resident physician places a patient’s home medications in for their admission orders during an overnight admission. They order the patient’s home medications including clobazam; however, they accidentally order clonazepam. Subsequently, the patient is over-sedated and has to be transferred to the ICU for airway monitoring. Which of the following is the most appropriate method for preventing future similar occurrences?

QID: 216598

Add an alert in the electronic medical system for medications that sound similar

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Enter medications only on morning rounds with multiple providers

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Have nursing perform the medication reconciliation

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Reprimand and educate the resident to check medications more carefully

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Verify the patient’s home medications with the patient

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M 11

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