What are the factors in which there are opportunities for mistakes?
ANSWER
Inconsistency
What are the modifications that are made to accommodate different input?
ANSWER
Variable Input
What is the factor that is more prone to failure because it is dependent on people?
ANSWER
Complexity
Which factor is defined as one where additional pressure is present because a process must
occur rapidly?
ANSWER
Tight Coupling
What factor is one in which these steps are followed so closely that the errors in one step
are not detected until the next step?
ANSWER
, Human Intervention
What is "the presence of additional pressure because the process must occur rapidly"?
ANSWER
Time Constraint
What is "levels of reporting that increase the opportunity for miscommunications"?
ANSWER
Hierarchical Culture
Scenario: After ringing the call bell a number of times, a patient tries to make it to the
bathroom on his own, but slips on a wet surface and falls. He is injured, but not
permanently.
Should this event be reported to the Joint Commission?
ANSWER
No
Scenario: After ringing the call bell a number of times, a patient tries to make it to the
bathroom on his own, but slips on a wet surface and falls. He is injured, but not
permanently.
ANSWER
Adverse Event
Continue
ANSWER
Inconsistency
What are the modifications that are made to accommodate different input?
ANSWER
Variable Input
What is the factor that is more prone to failure because it is dependent on people?
ANSWER
Complexity
Which factor is defined as one where additional pressure is present because a process must
occur rapidly?
ANSWER
Tight Coupling
What factor is one in which these steps are followed so closely that the errors in one step
are not detected until the next step?
ANSWER
, Human Intervention
What is "the presence of additional pressure because the process must occur rapidly"?
ANSWER
Time Constraint
What is "levels of reporting that increase the opportunity for miscommunications"?
ANSWER
Hierarchical Culture
Scenario: After ringing the call bell a number of times, a patient tries to make it to the
bathroom on his own, but slips on a wet surface and falls. He is injured, but not
permanently.
Should this event be reported to the Joint Commission?
ANSWER
No
Scenario: After ringing the call bell a number of times, a patient tries to make it to the
bathroom on his own, but slips on a wet surface and falls. He is injured, but not
permanently.
ANSWER
Adverse Event
Continue
