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Active Error (or Active Failure) - ANSWER-An error that occurs at the point of contact.
Active errors are generally readily apparent (e.g., pushing an incorrect button, ignoring a
warning light) and almost always involve someone at the front line. Active failures are
sometimes referred to as errors at the sharp end. Failures can be due to "latent" or
system failures or can be due to "active" or human failures.
Accreditation - ANSWER-One form of external review. The word technically means to
certify or credential, and in the realm of health care, it generally means that a delivery
system has met certain established standards that represent a minimally acceptable
level of performance. Accreditation of a health care system, hospital, ambulatory
surgery center and other care locations is considered by many to be a seal of approval
on which purchasers and consumers can base decisions about the quality and safety of
care provided.
ADE - Adverse Drug Event - ANSWER-An adverse event involving the use of
medications or the failure to use appropriate medications when indicated.
Administration Error - ANSWER-An error in the phase of the medication use process
where the drug product and patient interface.
ADR - Adverse Drug Reaction - ANSWER-An adverse drug reaction (ADR) is an
unwanted, undesirable effect of a medication that occurs during usual clinical use. An
ADR is an adverse effect produced by the use of a medication in the recommended
manner and may range from "nuisance effects" (e.g. dry mouth with anticholinergic
medications) to severe reactions, such as anaphylaxis to penicillin. ADR information is
frequently provided by the Institute for Safe Medication Practices (ISMP) in cooperation
with the FDA's MedWatch program.
AE - Adverse Event - ANSWER-an event, preventable or unpreventable, that caused
harm to a patient as a result of medical care. This includes never events;
hospital-acquired conditions; events that required life- sustaining intervention; and
events that caused prolonged hospital stays, permanent harm, or death. Any injury
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caused by medical care. An adverse event does not imply error, negligence or poor
quality care, but indicates that an undesirable clinical outcome resulted from some
aspect of diagnosis or therapy, not an underlying disease process. (also see Serious
Adverse Event)
AHRQ-Agency for Healthcare Research and Quality - ANSWER-The Agency for
Healthcare Research and Quality is one of twelve agencies within the United States
Department of Health and Human Services. It is the lead Federal agency charged with
improving the safety and quality of America's health care system. AHRQ develops the
knowledge, tools, and data needed to improve the health care system and help
Americans, health care professionals, and policymakers make informed health
decisions. www.ahrq.gov
Bar Code - ANSWER-Graphic representation of data (alpha, numeric, or both) that is
machine readable; a method of encoding numbers or alphabetic characters using wide
and narrow bars and spaces according to a set of rules called symbols. Scanning of a
bar code gives instant access to information in an associated database.
Benchmark - ANSWER-Healthcare benchmarking is taking an organization's
performance metrics and comparing those to a standard developed using data from
other similar organizations. The practice has been around in healthcare since roughly
1985. Leaders use benchmarking to learn where an organization is performing well
against its peers, and where it needs improvement. In healthcare, a benchmark is the
best in industry measurement that can drive improvement efforts to superior
performance.
Blunt End - ANSWER-The "blunt end" refers to the many layers of the health care
system not in direct contact with patients, but which influence the personnel and
equipment at the point of patient contact, the "sharp end". The blunt end refers to those
who set policy, manage health care institutions, design medical devices, and other
people and forces, which, though removed from direct patient care, affect how care is
delivered.
Call out - ANSWER-A call-out is a communication tactic used to related critical
information during an emergent event. Critical information called out in these situations
helps the team anticipate and prepare for vital next steps in patient care. It also benefits
a recorder when present during a code or emergent event. One important aspect of a
call-out is directing the information to a specific individual. Call-out technique is taught
during TeamSTEPPS® training.
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Check-Back - ANSWER-A process of using closed-loop communication to ensure that
information conveyed by the sender is understood by the receiver as intended.
Close Call - ANSWER-An event or situation that did not produce patient injury, but only
because of chance. The close call may be attributed to the robustness of the patient or
a fortuitous, timely intervention. Close calls are also called "near miss" incidents.
Competency - ANSWER-A competency is the capability to apply or use a set of related
knowledge, skills, and abilities required to successfully perform "critical work functions"
or tasks in a defined work setting.
Complexity Science (or Complexity Theory) - ANSWER-An approach to understanding
the behavior of systems that exhibit non-linear dynamics, or the ways in which some
Adaptive systems produce novel behavior not expected from the properties of their
individual components. Such behaviors emerge as a result of interactions between
agents at a local level in the complex system and between the system and its
environment.
CPOE (Computerized Physician Order Entry) - ANSWER-A computer based system for
ordering medications and/or other tests in which physicians directly enter orders into a
computer system.
Crew Resource Management (CRM) - ANSWER-A range of approaches to training
groups, originally developed in aviation, to function as teams, rather than as collections
of individuals that emphasizes the role of "human factors" and the impact of different
management styles and organizational cultures in high-stress, high-risk environments.
Also referred to as Crisis Resource Management.
Critical Incidents - ANSWER-Significant or pivotal occurrences in which significant harm
or potential for harm occurred and have the potential to reveal important hazards in the
organization and individual that can be remedied to prevent similar incidents in the
future.
Culture of Safety - ANSWER-The result of an organizational commitment to safety
permeating all levels from frontline personnel to executive management. Features of a
culture of safety include acknowledgment of the high-risk, error-prone nature of an
organization's activities, a Just Culture environment where individuals are able to report
errors and near misses without fear of reprimand or punishment, an expectation of
collaboration across ranks to seek solutions to vulnerabilities and a willingness on the
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Active Error (or Active Failure) - ANSWER-An error that occurs at the point of contact.
Active errors are generally readily apparent (e.g., pushing an incorrect button, ignoring a
warning light) and almost always involve someone at the front line. Active failures are
sometimes referred to as errors at the sharp end. Failures can be due to "latent" or
system failures or can be due to "active" or human failures.
Accreditation - ANSWER-One form of external review. The word technically means to
certify or credential, and in the realm of health care, it generally means that a delivery
system has met certain established standards that represent a minimally acceptable
level of performance. Accreditation of a health care system, hospital, ambulatory
surgery center and other care locations is considered by many to be a seal of approval
on which purchasers and consumers can base decisions about the quality and safety of
care provided.
ADE - Adverse Drug Event - ANSWER-An adverse event involving the use of
medications or the failure to use appropriate medications when indicated.
Administration Error - ANSWER-An error in the phase of the medication use process
where the drug product and patient interface.
ADR - Adverse Drug Reaction - ANSWER-An adverse drug reaction (ADR) is an
unwanted, undesirable effect of a medication that occurs during usual clinical use. An
ADR is an adverse effect produced by the use of a medication in the recommended
manner and may range from "nuisance effects" (e.g. dry mouth with anticholinergic
medications) to severe reactions, such as anaphylaxis to penicillin. ADR information is
frequently provided by the Institute for Safe Medication Practices (ISMP) in cooperation
with the FDA's MedWatch program.
AE - Adverse Event - ANSWER-an event, preventable or unpreventable, that caused
harm to a patient as a result of medical care. This includes never events;
hospital-acquired conditions; events that required life- sustaining intervention; and
events that caused prolonged hospital stays, permanent harm, or death. Any injury
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caused by medical care. An adverse event does not imply error, negligence or poor
quality care, but indicates that an undesirable clinical outcome resulted from some
aspect of diagnosis or therapy, not an underlying disease process. (also see Serious
Adverse Event)
AHRQ-Agency for Healthcare Research and Quality - ANSWER-The Agency for
Healthcare Research and Quality is one of twelve agencies within the United States
Department of Health and Human Services. It is the lead Federal agency charged with
improving the safety and quality of America's health care system. AHRQ develops the
knowledge, tools, and data needed to improve the health care system and help
Americans, health care professionals, and policymakers make informed health
decisions. www.ahrq.gov
Bar Code - ANSWER-Graphic representation of data (alpha, numeric, or both) that is
machine readable; a method of encoding numbers or alphabetic characters using wide
and narrow bars and spaces according to a set of rules called symbols. Scanning of a
bar code gives instant access to information in an associated database.
Benchmark - ANSWER-Healthcare benchmarking is taking an organization's
performance metrics and comparing those to a standard developed using data from
other similar organizations. The practice has been around in healthcare since roughly
1985. Leaders use benchmarking to learn where an organization is performing well
against its peers, and where it needs improvement. In healthcare, a benchmark is the
best in industry measurement that can drive improvement efforts to superior
performance.
Blunt End - ANSWER-The "blunt end" refers to the many layers of the health care
system not in direct contact with patients, but which influence the personnel and
equipment at the point of patient contact, the "sharp end". The blunt end refers to those
who set policy, manage health care institutions, design medical devices, and other
people and forces, which, though removed from direct patient care, affect how care is
delivered.
Call out - ANSWER-A call-out is a communication tactic used to related critical
information during an emergent event. Critical information called out in these situations
helps the team anticipate and prepare for vital next steps in patient care. It also benefits
a recorder when present during a code or emergent event. One important aspect of a
call-out is directing the information to a specific individual. Call-out technique is taught
during TeamSTEPPS® training.
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Check-Back - ANSWER-A process of using closed-loop communication to ensure that
information conveyed by the sender is understood by the receiver as intended.
Close Call - ANSWER-An event or situation that did not produce patient injury, but only
because of chance. The close call may be attributed to the robustness of the patient or
a fortuitous, timely intervention. Close calls are also called "near miss" incidents.
Competency - ANSWER-A competency is the capability to apply or use a set of related
knowledge, skills, and abilities required to successfully perform "critical work functions"
or tasks in a defined work setting.
Complexity Science (or Complexity Theory) - ANSWER-An approach to understanding
the behavior of systems that exhibit non-linear dynamics, or the ways in which some
Adaptive systems produce novel behavior not expected from the properties of their
individual components. Such behaviors emerge as a result of interactions between
agents at a local level in the complex system and between the system and its
environment.
CPOE (Computerized Physician Order Entry) - ANSWER-A computer based system for
ordering medications and/or other tests in which physicians directly enter orders into a
computer system.
Crew Resource Management (CRM) - ANSWER-A range of approaches to training
groups, originally developed in aviation, to function as teams, rather than as collections
of individuals that emphasizes the role of "human factors" and the impact of different
management styles and organizational cultures in high-stress, high-risk environments.
Also referred to as Crisis Resource Management.
Critical Incidents - ANSWER-Significant or pivotal occurrences in which significant harm
or potential for harm occurred and have the potential to reveal important hazards in the
organization and individual that can be remedied to prevent similar incidents in the
future.
Culture of Safety - ANSWER-The result of an organizational commitment to safety
permeating all levels from frontline personnel to executive management. Features of a
culture of safety include acknowledgment of the high-risk, error-prone nature of an
organization's activities, a Just Culture environment where individuals are able to report
errors and near misses without fear of reprimand or punishment, an expectation of
collaboration across ranks to seek solutions to vulnerabilities and a willingness on the
part of the organization to direct resources for addressing safety concerns
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