is a process improvement program that can be used to:
A. Reduce waste.
B. Find the root cause of an incident.
C. Help address disruptive behavior.
D. Eliminate variation.
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, C. Help address disruptive behavior.
TeamSTEPPS can be used to increase communication skills with teams and
reduce the risk of miscommunication that can lead to disruptive behavior.
In regard to the other answer options: Finding the root cause of an incident
is performing a root cause analysis. Reducing waste is Lean process
improvement, and eliminating variation is Six Sigma.
1. At the end of a long, exhausting shift, an experienced nurse administered the wrong
medication by picking up the wrong syringe. The wrong medication was an analgesic,
and the patient didn't suffer any problems. After recalling that his colleague was fired
last month over a medication error, he decides not to file an incident report. Safety
culture would be improved if the hospital provided this employee with which of the
following?
A. An electronic reporting system
B. Psychological safety
C. Situational awareness training
D. Training on reporting
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B. Psychological safety
In this case, regardless of whether the nurse has the knowledge or ability to
report the error, he is not speaking up because he does not feel
psychologically safe to do so. If the nurse felt psychologically safe, he
would feel confident that his concern would be heard and that appropriate,
system-focused action (as opposed to misplaced blame and punishment)
would ensue.
1. To improve culture of safety survey results, which of the following should an
organization do?
A. Offer coaching and apply Just Culture principles to leaders in lower performing
areas.
,B. Examine high-performing units to identify and disseminate best practices.
C. Perform root cause analysis on underperforming units to better understand their
results.
D. Acknowledge and celebrate high-performing areas in front of leadership.
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B. Examine high-performing units to identify and disseminate best
practices.
Identifying bright spots and applying the learning to other settings is the
best way to spread best practices. In regard to the other answer options:
Applying Just Culture principles could be perceived as a punitive response
to safety culture results; acknowledging high performers is important, but
in isolation is unlikely to drive change in other areas; and, lastly,
organizations most likely do not have the bandwidth to perform RCAs on
underperforming units, and doing so would be a misuse of root cause
analysis tools.
Centralized appointing staff are expected to use appointing guidelines to ensure
patients with urgent needs are seen promptly. After several delays in scheduling
appointments that should have been treated as urgent, what would be the strongest
action to prevent future mistakes?
A. Remind schedulers to use the scheduling guidelines for every patient and not just
when uncertain.
B. Educate schedulers about the importance of using the scheduling guidelines.
C. Ensure guideline updates are communicated to all schedulers.
D. Build the scheduling guidelines into the electronic appointing system.
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, D. Build the scheduling guidelines into the electronic appointing system.
The best answer is to build the scheduling guidelines into the electronic
appointing system. The other answers represent weaker actions to prevent
errors.
In December 2018, a hospital reports a clostridium difficile infection rate of 8 percent
and begins a series of infection prevention measures to reduce hospital-acquired
infections in general, including the use of stronger anti-bacterial cleaners throughout
the hospital and a hand hygiene awareness campaign. In December 2019, this hospital
reports a clostridium difficile infection rate of 4 percent.
What conclusion would you draw from this data?
A. Multiple infection prevention efforts are needed to drive down clostridium difficile
infection rates.
B. No conclusions can be drawn.
C. The hospital reduced their clostridium difficile infection rate, though one cannot tell
which intervention was most effective.
D. The hospital was successful in reducing their clostridium difficile infection rate in
2019.
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B. No conclusions can be drawn.The best answer is that no conclusions can
be drawn.
Simple comparisons between two values, no matter how easy they are to
make or how intuitive they appear to be, cannot fully convey the behavior
of data collected over time: both numbers are subject to the common
cause variation that is inevitably present in all data. The only way to get a
complete picture of what's happening in your organization is to graph data
over time, e.g., trended data with multiple data points.