HCQM-Patient Safety Exam
Complete Questions and Guide Answers
100% Verified Graded A+
1. First organization developed expressly to improve safety for patients.
Answer: Anesthesia Patient Safety Foundation - founded 1985.
2. Ellison Pierce
Answer: Established the Committee on Patient Safety and Risk Management in 1982; coined the term "patient safety",
founded the Anesthesia Patient Safety Foundation in 1985; delivered the Rovenstine Lecture in 1996.
3. 1996's Rovenstine Lecture (40 Years behind the Mask Safety Revisited)
Answer: Ellison Pierce described the beginning of anesthesiology's patient safety movement
4. 1982 20/20's The Deep Sleep 6000 will Die or Suffer Brain Damage
Answer: Inspired Pierce's Rovenstine Lecture about patient safety
5. After attending a workshop by Deming, Berwick realized he was misguided because he
had been
Answer: An inspector rather than a promoter of quality.
,6. 1988 Institute for Healthcare Improvement was founded by
Answer: Don Berwick, Paul Batalden, and Gene Nelson. The institute focuses on all aspects of quality, but their discovery of a
modern approach to quality helped transform the patient safety movement.
7. Harvard Medical Practice Study I and II
Answer: Published in 1991 by the New England Journal of
Medicine it had the results from two large studies of adverse medical events and provided the evidence that significant numbers of patien
are harmed by medical treatment and a framework for understanding the types of harm they experience.
8. Harvard Medical Practice Study I
Answer: 30,000 Medical records from 1984 non psych hospitals in
NYS were screened for adverse events (injury caused by medical management rather than underlying disease and prolonged the
hospitalization or produced a disability at the time of discharge) and negligence (care falling below the standard expected of physicians
their community).
9. Harvard Medical Practice Study II
Answer: Classified the injuries described in Study I and the management
errors that were responsible.
10. Results of Harvard Medical Study II
Answer: Adverse events occurred in 3.7% of hospitalizations and 27.6% of the events were due to negligence. 70.5%
gave rise to disability lasting less than six months, 2.6% caused permanently disabling injuries and 13.6% led to death.
, Unfortunately it did not lead to immediate change.
11. Lucian Leape
Answer: Co-author of the Harvard Medical Practice Study; prominent leader in the patient safety
movement; discovered how cognitive psychology and human factors engineering were important aspects of improving patient safet
12. 1994's Error in Medicine published in the Journal of the American Medical
Association
Answer: Written by Lucian Leape it presented statistical evidence of the occurrence of harm caused by medical errors along with
lessons from other high risk industries such as aviation.
13. The first mainstream article in healthcare literature arguing for a systems approach
to safety.
Answer: Error in Medicine by Lucian Leape.
14. In Error in Medicine, Leape identified 3 categories of medical errors
Answer: Medication errors, missed diagnoses, operational errors such as delayed treatment.
15. In Error in Medicine, Leape states the most fundamental change that must be made is
Answer: Cultural. Errors must be accepted as evidence of system flaws not character flaws.
16. Betsy Lehman 1994 Death
Answer: Occurred due to a medication error at Dana-Farber Cancer Institute. Published in the Boston Globe and
caused many to take Leape's Error in Medicine more seriously.
Complete Questions and Guide Answers
100% Verified Graded A+
1. First organization developed expressly to improve safety for patients.
Answer: Anesthesia Patient Safety Foundation - founded 1985.
2. Ellison Pierce
Answer: Established the Committee on Patient Safety and Risk Management in 1982; coined the term "patient safety",
founded the Anesthesia Patient Safety Foundation in 1985; delivered the Rovenstine Lecture in 1996.
3. 1996's Rovenstine Lecture (40 Years behind the Mask Safety Revisited)
Answer: Ellison Pierce described the beginning of anesthesiology's patient safety movement
4. 1982 20/20's The Deep Sleep 6000 will Die or Suffer Brain Damage
Answer: Inspired Pierce's Rovenstine Lecture about patient safety
5. After attending a workshop by Deming, Berwick realized he was misguided because he
had been
Answer: An inspector rather than a promoter of quality.
,6. 1988 Institute for Healthcare Improvement was founded by
Answer: Don Berwick, Paul Batalden, and Gene Nelson. The institute focuses on all aspects of quality, but their discovery of a
modern approach to quality helped transform the patient safety movement.
7. Harvard Medical Practice Study I and II
Answer: Published in 1991 by the New England Journal of
Medicine it had the results from two large studies of adverse medical events and provided the evidence that significant numbers of patien
are harmed by medical treatment and a framework for understanding the types of harm they experience.
8. Harvard Medical Practice Study I
Answer: 30,000 Medical records from 1984 non psych hospitals in
NYS were screened for adverse events (injury caused by medical management rather than underlying disease and prolonged the
hospitalization or produced a disability at the time of discharge) and negligence (care falling below the standard expected of physicians
their community).
9. Harvard Medical Practice Study II
Answer: Classified the injuries described in Study I and the management
errors that were responsible.
10. Results of Harvard Medical Study II
Answer: Adverse events occurred in 3.7% of hospitalizations and 27.6% of the events were due to negligence. 70.5%
gave rise to disability lasting less than six months, 2.6% caused permanently disabling injuries and 13.6% led to death.
, Unfortunately it did not lead to immediate change.
11. Lucian Leape
Answer: Co-author of the Harvard Medical Practice Study; prominent leader in the patient safety
movement; discovered how cognitive psychology and human factors engineering were important aspects of improving patient safet
12. 1994's Error in Medicine published in the Journal of the American Medical
Association
Answer: Written by Lucian Leape it presented statistical evidence of the occurrence of harm caused by medical errors along with
lessons from other high risk industries such as aviation.
13. The first mainstream article in healthcare literature arguing for a systems approach
to safety.
Answer: Error in Medicine by Lucian Leape.
14. In Error in Medicine, Leape identified 3 categories of medical errors
Answer: Medication errors, missed diagnoses, operational errors such as delayed treatment.
15. In Error in Medicine, Leape states the most fundamental change that must be made is
Answer: Cultural. Errors must be accepted as evidence of system flaws not character flaws.
16. Betsy Lehman 1994 Death
Answer: Occurred due to a medication error at Dana-Farber Cancer Institute. Published in the Boston Globe and
caused many to take Leape's Error in Medicine more seriously.
