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CP > Culture > Flashcards

Culture Flashcards

1
Q

What is the first element of an ideal safety culture?

A

Collect, analyze, share safety information

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2
Q

What is the second element of an ideal safety culture

A

Error reporting and feedback loops (front line engaged); sensitivity to errors

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3
Q

What is the third element in an ideal safety culture

A

Fair and just response to errors

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4
Q

What is the fourth element of an ideal safety culture

A

Flexibility to restructure when necessary, defer to expertise, reduce hierarchy

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5
Q

What is the fifth element an ideal safety culture

A

Willingness to learn from errors

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6
Q

Culture: local or organizational?

A

Local unit level culture as focus of evaluation and action

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7
Q

What are 2 high focus areas when interpreting and responding to safety culture survey data

A

Teamwork and communication

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8
Q

What is the typical threshold and survey response rates

A

60%

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9
Q

Should you identify disseminate best practices from high performing work units based on survey results

A

Yes

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10
Q

What does high level of voluntary reporting of near Mrs. suggest of a culture?

A

A culture is advanced enough that Frontline understand what makes a defect system failure even if it doesn’t reach the patient

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11
Q

What are other ways to back up voluntary reporting

A

Observations and technology

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12
Q

Does leadership active involvement in prioritizing patient safety suggest a strong culture

A

Yes

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13
Q

What are three groups that should be involved in patient safety initiatives

A

Leadership, multidisciplinary engagement, patient and family involvement

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14
Q

What is a example of standardization

A

Color coded wristbands that reduce errors within departments across organizations and throughout the industry

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15
Q

What are checklists?

A

List of actions that should be performed to optimize patient outcomes

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16
Q

What are examples of checklists?

A

Surgical safety checklist, handoffs, Keystone ICU project

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17
Q

Should you personalize or you storytelling in error reporting a near miss education?

A

Yes

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18
Q

What is the science of human factors the study of

A

The inter-relationship between humans, the tools and equipment they use in the workplace, and the environment in which they work

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19
Q

What are the six elements of a high performing team?

A

Team structure, leadership, communication, situation monitoring, mutual support, coordination and collaboration.

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20
Q

What are three barriers to disclosure of unexpected outcomes

A

Like a culture of safety, psychological barriers, legal barriers.

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21
Q

What is the term that provides the patient family with all of the information needed for appropriate care decisions?

A

Effective disclosure

22
Q

What are six process steps for the conversation to patient/family?

A

Designated personnel roles, conversation outlines, special communication needs accommodations, support services, steps for follow-up conversations, and documentation

23
Q

What are five things that the lack of health literacy leads to?

A

Readmissions, and ability to navigate the healthcare spectrum, increased health cost, limited preventative medicine, self report of poor health

24
Q

What is the belief that no one will be punished or humiliated for speaking up with ideas questions concerns or mistakes?

A

Psychological safety

25
Q

Building psychological safety requires what?

A

Softening of authority gradients

26
Q

The single greatest impediment to air prevention in the medical industry is?

A

We punish people for making mistakes

27
Q

What are three key facts about human error

A

Cannot be eradicated, error is part of the human condition, we must learn from errors

28
Q

How can consequences of errors be mitigated?

A

Anticipate predictable errors, build safe processes, enhance communication skills and teamwork

29
Q

Managing at risk behavior requires what two things?

A

Feedback and coaching

30
Q

What is one thing reckless behavior requires?

A

Administrative consequence

31
Q

What is the organizational accountable for in a just culture?

A

Designing safe systems that encourages and supports safe choices of staff

32
Q

What are clinicians and staff accountable for in a just culture?

A

Accountable for the quality of their choices. 

33
Q

Define just culture

A

Don’t simply punish people because of their actions, but always hold them accountable for their decisions

34
Q

The cognitive process of automatic processing leads to what?

A

Slips and lapses, errors of execution

35
Q

What are examples of errors of execution

A

Interruptions, fatigue, time pressure, anger, anxiety, fear, boredom

36
Q

What is right plan/intention, but do it wrong called?

A

Error of execution

37
Q

What is intended action/plan but not the correct one called?

A

Errors of planning

38
Q

Conscious processing (problem solving) leads to what?

A

Mistakes – errors are planning

39
Q

Behavioral choice that increases risk where risk is not recognized or is mistakenly believed to be justified is called what?

A

At risk behavior

40
Q

What are three justifications for at risk behavior?

A

Normalized defiance, workaround, drift

41
Q

What are two common at risk behavior failures?

A

Hand hygiene and two patient identifiers

42
Q

What three concepts creates incentive to do at risk behavior?

A

Consequences are weaker than the rules, consequences are uncertain, consequences are delayed or not apparent.

43
Q

What is the conscious behavioral choice to disregard a substantial and unjustifiable risk such as a rule procedure law or policy?

A

Reckless behavior

44
Q

What is no intention to cause harm

A

Reckless behavior

45
Q

Which behavioral choice has a need to adjust to highly variable conditions, and is comfortable with inherit risk/threats?

A

Drift

46
Q

When team members make choices to go against policy to become more efficient, it is called what?

A

Workarounds

47
Q

Why Should you consider other inputs before defining actions based on the survey results?

A

Because culture is multi factorial

48
Q

You’rreducation clinical managers in your healthcare facility on how to identify appropriate events for a RCA. Whixh event provides the best opportunity for an RCA?

A

Biopsy samples from my colonoscopy or never received by pathology after the procedure

49
Q

Should you ask the nurse what was occurring at the time and why she chose to bypass the policy when she did not comply with the BCMA? 

A

Yes

50
Q

If a surgeon leaves the hospital to catch a flight before the surgery is finished and the x-ray reveals a retained instrument what should leadership do next?

A

Counsel the surgeon about clinical standards using appropriate accountability system

CP (6 decks)

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