PPS info Flashcards
Brainstorming definition
Stimulating creative thinking and generation of ideas in response to problems
Buzz groups defintion
Turning to neighbours to consider concepts
Snowballing definition
Participants work in progressively larger groups to that individuals join to pairs, pairs to fours, fours to eights etc, ensuring full participation
Rounds definition
Each person has 30s to 1 minute to discuss the topic, useful at the beginning of a session
Line ups definition
Asked to adopt a position on a line which represents their view on an issue
Circular interviewing/questioning definition
Similar to rounds but each person asks a question, usually to the person opposite them, continues until everyone has contributed
What is diversity
Understanding ourselves
Define health
The state of complete physical, mental and social wellbeing and not merely the absence of disease or deformity
Human rights act 1998
Irreducable moral status of individuals demands that people are treated in ways that are compatible with that moral status
HRA: Article 2
The right to life
HRA: Article 3
The right to be free from inhuman and degrading treatment
HRA: Article 8
The right to respect for privacy and family life
HRA: Article 12
The right to marry and found a family
HRA: Article 14
The enjoyment of rights and freedoms irrespective of discrimation
Define utilitariansim
Maximising good for the maximum number of people
Why have rationing needs increased
Increased demand
More chronic long term illnesses
Medicalisation of normal events like childbirth
Increase in choice and expensive drugs
Egalitarian principles
NHS was founded on a requirement to provide all care that is necessary and appropriate to everyone
What are maximising principles
Essentially utilitarianism
Criteria the maximise public utility
Libertarian principles
Each is responsible for their own health, well being and fulfilment of life plan
Leadership models
Laissez faire
Transactional
Transformational
Laissez faire leadership
Delegation of responsibility
Transactional leadership
Supervision, reward and punishment
Transformational leadership
Inspiring your team, getting the most out of them
What is a doctor in terms of clnical decision making
One who has ultimate responsibilty for difficult decisions using knowledge and judgement
Aristotle moral virtues
Courage
Integrity
Aristotle intellectual virtues
Knowledge
Skill
Judgement
Why is risk estimation hard
People are not good at estimating odds
Decision making systems
Kahneman and Tversky
What is the kahneman tversky decision model
Pattern recognition.
Novices decide analytically, experts decide using intuition
Intuitive decision making
Ability to understand something instantly without conscious reasoning. Recognition and heuristic. Irresistable.
Advantages and disadvantages of pattern recognition decision making
Fast and frugal
Prone to biases
How to reduce risks of intuition
Decision environment and process
Personal debiasing techniques
Cognitive
Structural debiasing
Dual process thoery
Intuitive thinking with its irresistable combinatino of heuristics and biases, together with analytical thinking, using evidence based medicine
What causes most medical errors
Miscommunication
Human factors which can cause issues
Loss of situational awareness
Perception and cognition
Teamwork
Culture
What is the swiss cheese model
Where a series of failed of absent diseases fail to prevent accident and injury
What type of conditions allign in swiss cheese model
Latent and active conditions
What determines behaviour intention and therefore behaviour
Attitude toward behaviour
Subjective norm
Percieved behaviour control
Person approach to human factors
Focus on individual
Blame/fault
Retrain, discipline, shame
Target individual
System approach to human factors
Focus on the working conditions Recognise errors Implement defences Create better systems Target team, task, workforce
Define never events
Serious, largely preventable patient safety incidents that should not occur if the available preventative measures have been implemented. Intolerable and inexcusable
Sloth error
Not bothered. Concientiousness counters this
Fixation and loss of perspective error
Overlooking, unshakeable. Open mindedness and situational awareness counters this
Communication breakdown error
Unclear and not listening. Effective communication overcomes this
Poor team working error
Independent, poor direction. Good team working overcomes this
Playing the odds error
Choosing the common and dismissing the rare. Probability assessment overcomes this
Bravado error
Working beyond competence. Humility overcomes this
Ignorance error
Unconcious incompetence, self awareness overcomes this
Mis triage error
misestimating the seriousness of a situation, prioritisation overcomes this
Lack of skill error
Lack of appropriate skills, teaching or practise. Effective technical skills overcome this
System error
Environmental, technology, equipment or organisational features. Inadequate built in safeguards. System design overcomes this
Three key duties of a doctor
Knowledge, skills and performance
Safety and quality
Maintaining trust
4 categories of how things go wrong
Human error
Neglect
Poor performance
Misconduct
Do harm and error link
Harm doesnt always lead to error and visa versa. Analysing these can show patterns
3 categories of human error
Communication
Judgement error
Omissions, lapses, violations
4 tests for medical negligence
Was there a duty of care
Was there a breach in the duty of care
Did the patient come to harm
Did the breach cause the harm
Describe medical negligence
Legal entity. Civil claim for damages. On balance of probabilities. Can be found liable but not guilty
Examples of neglect
Below accepted standard Repeated minor mistakes Not caring Safeguarding Nutrition and care Medical care
Examples of poor performance
Attitude Rude, tardy, scruffy Failure to improve Affects patient care Usually evident from study days
Examples of misconduct
Deliberate harm
lack of candour
hiding mistakes
altering records
What is candour
Open and honest
Examples of fraud/theft
False expense claims
Time: sickness
Drug and alcohol problems
Examples of improper relationships
Patients, relatives, colleagues
