Organizational influences and patient outcomes Flashcards
A culture of safety is promoted by what 5 factors?
- the health care organization’s commitment to patient safety above all goals
- a commitment to safety at all levels of the organization
- A focus on systems, process improvement, and individual accountability
- sufficient resources
- the ability of providers to discuss near miss events and errors without reprisal
What are 3 US state regulatory organization?
- public health departments
- licensing boards
- insurance commissioners
What are 2 professional organizations?
- ambulatory surgery center association
2. association of perioperative RN’s
What are 3 US accreditation agencies?
- DNV GL
- Accreditation Association for Ambulatory health care
- the joint commission
What has been a result of landmark reports?
there has been a shift from a culture of placing blame on an individual when errors occur to creating safer health care systems and standardizing processes.
The universal protocol for preventing wrong site, wrong procedure, and wrong person surgery consists of three key steps:
- conducting a pre-procedure verification process
- marking the procedure site
- performing a time out
What can affect patient care?
- human factors and the culture of the health care
Errors caused by team members can be what 3 things?
- skill-based behavior error
- knowledge-based performance error
- situational factor error
What is skill-based behavior error?
the provider has the knowledge for the action and there is little or not attention or attention is diverted
What is knowledge-based performance error?
mistakes include errors in perception, judgement, interference, or interpretation
What is situational factor error?
lack of attention and situational factors play a significant factors play a significant role in this type of error
The surgical safety checklist was an initiative of who?
The Who
A short dialogue for planning before the start of an operative or invasive procedure to discuss team formation, assign essential team roles, establish expectations and climate, and anticipate outcomes.
briefing
A short dialogue conducted after the procedure has concluded that is designed to improve team performance and effectiveness.
debriefing
An organization that carries out complex and hazardous work while minimizing adverse events.
high reliability organization
An unplanned or unexpected event causing discontinuation of a task.
interruption
A culture that balances personal accountability and system improvement.
just culture
A culture in which every perioperative team member places value on safety and commits to personal responsibility for patient safety.
patient safety culture
The pause in patient care activity taken by the surgical team immediately before the start of the procedure to conduct a final assessment that the correct patient, site, positioning, and procedure are identified and that, as applicable, all relevant documents, related information, and necessary equipment are available.
time out
The act of identifying the correct site on the patient’s body where the operative or invasive procedure is to be performed
site marking