PPD Flashcards
Why does Human error occur
Communication
Judgement error
Omission, lapses, violations
What is neglect
Falling below the accepted standard
Stems from repeated minor mistakes and a culture of not caring
Mid-Staffordshire
Why does poor performance occur
Attitude problem
Failure to learn from mistakes
Affects patient care
What is misconduct
Deliberate harm
Lack of candour
Fraud/theft
Improper relationships
What are some examples of lack of candour
Hiding mistakes
Ignoring mistakes
Altering medical records
What are some examples of fraud/theft
False expenses claims
Time off -sickness
What is medical negligence
Legal entity
Laible not guilty of
What are the four domains of neglience?
Was there a duty of care?
-offer advice - accepted duty of care
Was there a breach in duty of care
- Bolam test
- Bolitho test
Did the patient come to harm?
Did the breach cause the harm?
What is the bolam test? What is the Bolitho test
Would a group of reasonable doctors do the same?
Would it be reasonable of them to do so?
What is intuitive decision making
Ability to understand something instantly without conscious reasoning
Advantages
-fast and frugal: Heuristics
Disadvantage
-prone to biase
What are the advantages and disadvantages of analytical decision making
requires infromation, knowledge, processing skill
- hypothesis testing
- exhaustive
advantages
-accurate, reliable
Disadvantage
- slow, demanding
What is Peyton’s four step procedure for skills training
Trainers runs though, no commentary
Trainer talks through and trainer does
Learner talks through and trainer does
Learner talks through, learner does
What are some leadership theories
Great man theory
Trait theory
Behavioural theory
-how leaders behave towards team
Contingency
-leadership style depends on situation e.g. telling - low competence, deligating - high competence
Transactional
-reward and punishment to motivate behaviorus
Transformationa
-taps into needs and values and inspires with new possibilities, raising level of confidence, conviction
Is there a right to medical care
Article 2 - state obliged to take appropriate steps to safeguard life
But cannot impose disproportionate burden on the authorities
What is a judicial review
Opportunity for an individual to challenge the exercise of power by a public body
What is ethnocentrism
evaluate other groups according to the values of one’s own cultural group
What is a stereotype
generalisation about typical characteristics of members of a group
What is prejudice
Attitude towards another person based soley on their membership of a group
What is discrimination
positive or negative actions towards objects of prejudice
What is the most common cause of medical error
Miscommunciation 70%
What mechanisms may cause inhumane behavioiur
Bystander effect
Conformity
-unwillingness to speak against a prevailing view
Pressing situational factors overriding value ystems
What are some examples of never events
Serious, largely preventable safety incidents that should not occur if the available preventative measures are implemented.
Surgery
- wrong site or implanted
- retained foreign object
Medication
- wrong preparation
- wrong route
- overdose
Mental health
-suicide
General heatlhcare
- entrapment in bed rails
- misplaced NG tube
- Misidentification
Maternity
-Death due to PPH
What is the structure of quality improvement
Assessment
Diagnosis
Treatment
Standardise
What is the difference between common cause variation and special cause variation
Common cause
- chance cause
- due to multiple factors within the system
- random
Special cause
- assignable cause
- statistically sign
- shows change
