Patient Safety, Law and Ethics

Question 1

What is value-based care?

Answer 1

1. Addressing patients’ concerns
2. Improving QOL
3. Enabling essential ADL/ Minimizing ADL impairment

Question 2

What are the 4 components of the Swiss Cheese Model?

Answer 2

1. Organization influences
2. Unsafe Supervision
3. Preconditions for unsafe acts
4. Unsafe acts

Question 3

What is HFACS?

Answer 3

1. Systematic approach to incident analysis
2. Used to Identify active and latent failures
3. Establish Causes and Effect which is essential for identification of correct root causes and corresponding corrective actions
4. Promote Just Culture and avoid blaming

Question 4

What is reliability in healthcare?

Answer 4

1. Consistent High Quality
2. Exceptional safety

Question 5

Reliability in healthcare _______ equate to zero harm or error.

Answer 5

does not

Question 6

Name the 6 ways in which errors can be minimized in decreasing effectiveness.

Answer 6

1. Eliminate opportunity for error
2. Make it hard to do the wrong thing
3. Make it easy to do the right thing
4. Make errors more visible
5. Minimize injury
6. Policies, Trainings, Inspection

Question 7

What is Just Culture for?

Answer 7

It is to prevent “knee jerk” reaction whereby the last person touching/ causing the issue is being put blame on before investigation.

Question 8

What is the use of an incident decision tree?

Answer 8

Reviews systematic and organizational issues associated with human errors to prevent “knee jerk”

Question 9

Incident decision tree does not eliminate potential for ______ that may occur during investigation.

Answer 9

human biases

Question 10

Why is open communication important?

Answer 10

Because patients have the rights to know, helps build trust and assurance and allow organization to learn from it

Question 11

What are the two barriers to open communication?

Answer 11

1. Fear
2. Not trained

Question 12

Who may conduct open communication?

Answer 12

HCPs and also people who are trained.

Note: Not all HCPs are expected to perform it

Question 13

What is the Chatham House Rule?

Answer 13

Require identifiable information to be anonymized when useful information is shared outside of defined setting

Question 14

What is tort?

Answer 14

Wrongful acts that can be at individual and corporate levels

Question 15

What is bolam?

Answer 15

Accepted current practice (Someone would have acted the same way you did)

Question 16

What is bolitho?

Answer 16

Evidence-based medicine and Logical thinking (A body of experts might have the same mistakes in the same scenario)

Question 17

What is occupier liability?

Answer 17

Someone with control/ power/ influence over premises

Question 18

Under occupier liability, occupiers are __________ to be insurers of properties’ safety

Answer 18

not expected

Question 19

When is duty of care owed by occupier?

Answer 19

1) Factual Foreseeability
2) Legal proximity between parties
3) Public policy considerations

Question 20

What is vicarious liability?

Answer 20

Employer liable for torts committed by employees within employment (employer-employee relationship)

Question 21

Employers should be liable for _________ services like locum pharmacist under the vicarious liability.

Answer 21

3rd party

Question 22

Under the vicarious liability, independent contractor does not have ______ to control.

Answer 22

Rights

Question 23

Criminal and civil law _____ run concurrently.

Answer 23

can

Question 24

Both criminal and civil law ____ be subjected to professional organization implication.

Answer 24

can

Question 25

What is criminal law?

Answer 25

Offence chargeable under law

Question 26

What is a civil law?

Answer 26

Deals with rights of individual entities.

Question 27

What are the two routes in civil law?

Answer 27

1. Tort 2. Contract

Question 28

What is autonomy?

Answer 28

Respect for person choices as they have the freedom to form their own judgement

Question 29

When is autonomy absent?

Answer 29

Coercion, ignorance, immaturity, mental incapacity

Question 30

What is Beneficence?

Answer 30

To do good

Question 31

What is Non-maleficence?

Answer 31

Do no harm

Question 32

What is justice?

Answer 32

Fairness

Question 33

What is fidelity?

Answer 33

Truth telling and maintenance of confidentiality

Question 34

What is veracity?

Answer 34

Relationship based on mutual trust and honesty

Question 35

What is the litmus test?

Answer 35

Acting ethically when nobody is watching

Question 36

What is medical negligence?

Answer 36

Failure to exercise acceptable standard of care in skills and knowledge

Question 37

What are the 4 components in medical negligence?

Answer 37

1. Duty of care 2. Breach of standard of care 3. Causation 4. Foreseeable Damages or Injuries

Question 38

When is duty of care established?

Answer 38

When patient is receiving treatment, being assessed or reviewed by HCP

Question 39

What does standard of care refers to?

Answer 39

Care should be delivered based on evidence -based clinical principle

Question 40

When is causation established?

Answer 40

When lack of care on HCP’s part causes injury or harm

Question 41

What is Res ipsa loquitor?

Answer 41

Facts shall speak for themselves

Question 42

How does Res ipsa loquitor help patients during defense?

Answer 42

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

Question 43

How can HCP refute causation during defense?

Answer 43

Informed consent have been provided. Contributory negligence by patient themselves further contribute to injuries

Question 44

What is foreseeable damage?

Answer 44

Damage that is not too remote

Question 45

What are the rights of patients?

Answer 45

1. To know about treatment 2. To know the HCP involved in treatment 3. To make own decisions

Question 46

What are the responsibilities of patients?

Answer 46

1. To adhere to checkups 2. To provide relevant information to HCPs 3. To clarify when in doubt