QIHC Exam 3 questions with verified
correct solutions
Behavioral change approach grounded in commercial marketing theory.
4Ps - Product, price, place, promotion
Focus on buying into beneficial behavior, not product
ex: Click it or ticket - ANS ✔Social Marketing
"Vision for RM is to build resilient systems and providers with goal of zero avoidable harm"
-Risk measure in likelihood and -consequence
-Quality measure in 6 IOMs
-To manage: identify, analyze, control - ANS ✔Risk Management
Identify, analyze, control - ANS ✔How to manage risk?
-focus on errors in earliest manifestation while avoiding disaster
-try to understand process in depth, not simple
-emphasize knowledge of operation, learn on front lines
-resilience to overcome errors
-listen & respect experience/expertise - ANS ✔High reliability organization
, Values reporting (no punitive analysis), culture is just (no scapegoating), flexible (free
information flows), values learning (new understanding is desired) - ANS ✔Strong safety culture
collect data --> information --> knowledge --> action/decision
Collect: data alone is isolated fact
Information: data is meaningful (answers questions/show opportunities)
Knowledge: Prediction of capacity of similar future event
Decisions: Action or inaction of improvements (through collaborate change) - ANS ✔Data to
decision cycle
"Generic error modeling system"
-common errors
-inaction in action sequence and/or errors in a plan/exectuion
-Skill based slips (failure in execution - order IV, writes oral)
-Skill based lapse (legs crossed for BP)
-Rule based mistake (original assumed diagnosis shown wrong by confirmatory test -- RBC, RQ
pain assumed appendicitis, labs show it is not)
-Knowledge based mistake (conformational bias)
-Violations of rules or norms
MOST COMMON: the two SKILL-BASED - ANS ✔GEMS Error Framework
-Once we know errors occur, how to prevent/minimize? Easiest to correct is SKILL based. (then
rule based, then knowledge, then intentional)
-Classification system bust support appropriate response to human errors
correct solutions
Behavioral change approach grounded in commercial marketing theory.
4Ps - Product, price, place, promotion
Focus on buying into beneficial behavior, not product
ex: Click it or ticket - ANS ✔Social Marketing
"Vision for RM is to build resilient systems and providers with goal of zero avoidable harm"
-Risk measure in likelihood and -consequence
-Quality measure in 6 IOMs
-To manage: identify, analyze, control - ANS ✔Risk Management
Identify, analyze, control - ANS ✔How to manage risk?
-focus on errors in earliest manifestation while avoiding disaster
-try to understand process in depth, not simple
-emphasize knowledge of operation, learn on front lines
-resilience to overcome errors
-listen & respect experience/expertise - ANS ✔High reliability organization
, Values reporting (no punitive analysis), culture is just (no scapegoating), flexible (free
information flows), values learning (new understanding is desired) - ANS ✔Strong safety culture
collect data --> information --> knowledge --> action/decision
Collect: data alone is isolated fact
Information: data is meaningful (answers questions/show opportunities)
Knowledge: Prediction of capacity of similar future event
Decisions: Action or inaction of improvements (through collaborate change) - ANS ✔Data to
decision cycle
"Generic error modeling system"
-common errors
-inaction in action sequence and/or errors in a plan/exectuion
-Skill based slips (failure in execution - order IV, writes oral)
-Skill based lapse (legs crossed for BP)
-Rule based mistake (original assumed diagnosis shown wrong by confirmatory test -- RBC, RQ
pain assumed appendicitis, labs show it is not)
-Knowledge based mistake (conformational bias)
-Violations of rules or norms
MOST COMMON: the two SKILL-BASED - ANS ✔GEMS Error Framework
-Once we know errors occur, how to prevent/minimize? Easiest to correct is SKILL based. (then
rule based, then knowledge, then intentional)
-Classification system bust support appropriate response to human errors
