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Updated: Mar 6 2023

Quality and Safety

  • Adverse Events
    • Adverse events are injury due to medical or surgical treatment and can be divided into
      • preventable adverse event
        • those injuries that could have been avoided if accepted practice or protocols had been followed
      • non-preventable adverse event
        • those injuries that could not have been avoided even with optimal medical care
    • Sentinel event
      • any unexpected occurrence involving death or serious physical or psychological injury, or the risk thereof
      • requires immediate investigation, discovery of the cause, and response
    • Near miss
      • potential adverse event that could have caused harm but did not
      • provide opportunities for developing preventive strategies and action
    • Malpractice
      • improper, negligent, or illegal activity by a medical practitioner
  • 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
    • Prevention of wrong-site, wrong-procedure, or wrong-patient surgery
      • Joint Commission Universal Protocol
        • Conduct a pre-procedure verification process
        • Mark the procedure site
        • Perform a time-out
  • 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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