Patient Safety, Law and Ethics Flashcards
What is value-based care?
- Addressing patients’ concerns
- Improving QOL
- Enabling essential ADL/ Minimizing ADL impairment
What are the 4 components of the Swiss Cheese Model?
- Organization influences
- Unsafe Supervision
- Preconditions for unsafe acts
- Unsafe acts
What is HFACS?
- Systematic approach to incident analysis
- Used to Identify active and latent failures
- Establish Causes and Effect which is essential for identification of correct root causes and corresponding corrective actions
- Promote Just Culture and avoid blaming
What is reliability in healthcare?
- Consistent High Quality
- Exceptional safety
Reliability in healthcare _______ equate to zero harm or error.
does not
Name the 6 ways in which errors can be minimized in decreasing effectiveness.
- Eliminate opportunity for error
- Make it hard to do the wrong thing
- Make it easy to do the right thing
- Make errors more visible
- Minimize injury
- Policies, Trainings, Inspection
What is Just Culture for?
It is to prevent “knee jerk” reaction whereby the last person touching/ causing the issue is being put blame on before investigation.
What is the use of an incident decision tree?
Reviews systematic and organizational issues associated with human errors to prevent “knee jerk”
Incident decision tree does not eliminate potential for ______ that may occur during investigation.
human biases
Why is open communication important?
Because patients have the rights to know, helps build trust and assurance and allow organization to learn from it
What are the two barriers to open communication?
- Fear
- Not trained
Who may conduct open communication?
HCPs and also people who are trained.
Note: Not all HCPs are expected to perform it
What is the Chatham House Rule?
Require identifiable information to be anonymized when useful information is shared outside of defined setting
What is tort?
Wrongful acts that can be at individual and corporate levels
What is bolam?
Accepted current practice (Someone would have acted the same way you did)
What is bolitho?
Evidence-based medicine and Logical thinking (A body of experts might have the same mistakes in the same scenario)
What is occupier liability?
Someone with control/ power/ influence over premises
Under occupier liability, occupiers are __________ to be insurers of properties’ safety
not expected
When is duty of care owed by occupier?
1) Factual Foreseeability
2) Legal proximity between parties
3) Public policy considerations
What is vicarious liability?
Employer liable for torts committed by employees within employment (employer-employee relationship)
Employers should be liable for _________ services like locum pharmacist under the vicarious liability.
3rd party
Under the vicarious liability, independent contractor does not have ______ to control.
Rights
Criminal and civil law _____ run concurrently.
can
Both criminal and civil law ____ be subjected to professional organization implication.
can
What is criminal law?
Offence chargeable under law
What is a civil law?
Deals with rights of individual entities.
What are the two routes in civil law?
- Tort
- Contract
What is autonomy?
Respect for person choices as they have the freedom to form their own judgement
When is autonomy absent?
Coercion, ignorance, immaturity, mental incapacity
What is Beneficence?
To do good
What is Non-maleficence?
Do no harm
What is justice?
Fairness
What is fidelity?
Truth telling and maintenance of confidentiality
What is veracity?
Relationship based on mutual trust and honesty
What is the litmus test?
Acting ethically when nobody is watching
What is medical negligence?
Failure to exercise acceptable standard of care in skills and knowledge
What are the 4 components in medical negligence?
- Duty of care
- Breach of standard of care
- Causation
- Foreseeable Damages or Injuries
When is duty of care established?
When patient is receiving treatment, being assessed or reviewed by HCP
What does standard of care refers to?
Care should be delivered based on evidence -based clinical principle
When is causation established?
When lack of care on HCP’s part causes injury or harm
What is Res ipsa loquitor?
Facts shall speak for themselves
How does Res ipsa loquitor help patients during defense?
Patient can argue that layperson not trained to tell how negligence and this results in injuries. Since the HCP cannot provide an explanation, he or she is liable for damages
How can HCP refute causation during defense?
Informed consent have been provided. Contributory negligence by patient themselves further contribute to injuries
What is foreseeable damage?
Damage that is not too remote
What are the rights of patients?
- To know about treatment
- To know the HCP involved in treatment
- To make own decisions
What are the responsibilities of patients?
- To adhere to checkups
- To provide relevant information to HCPs
- To clarify when in doubt
