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Hospital leadership is concerned about low safety culture survey scores in the category of communication openness, The percentage of positive responses related to questioning someone with higher authority is well below national averages. The lead patient safety professional has been asked to make recommendations on increasing the questioning of those with higher authority. To maximize risk reduction, the patient safety professional should recommend that staff be asked to stop and question whenever: a. Something doesn't seem right b. A discrepancy has been confirmed c, Patient harm is likely d. A protocol was not followed- ¥ Answer ¥ -a, Something doesn't seem right In Cause Analysis, the role of the Executive Sponsor is to: a. Complete the initial debrief following a patient safety event, and ensure the safety of all involved. b, Prepare for a visit by the department of health if the event meets criteria for reporting to the state. c. Help scope the objectives and maintain accountability for effective and timely action plans. d. Coordinate all efforts of the cause analysis team and conduct performance management discussions.- V After significant time since the last sentinel event, hospital leadership has learned of the reoccurrence of a sentinel event believed to have been previously resolved. The most likely cause of this repeat event is: a. Staff are not familiar with safety policies and protocols due to significant turn over b. Leadership has stopped messaging on safety since significant time has passed since the last sentinel event c. Drift to old habits over time have slowly eroded safer practice d, Negative changes in culture have reduced event reporting- Y Answer / -b, Leadership has stopped Near-miss error event reporting is more likely when: a. The safety event electronic reporting process includes details and staff names b. The reporter has a week to report the near miss c. Reporting errors and near-misses are required by leadership d, Feedback and follow-up by leaders is provided to the reporter- J Answer ¥ -d, Feedback and follow- Your patient safety team performs a root cause analysis on a recent wrong side surgery event. Which of the following action items reflects the highest level of reliability? a. Perform multidisciplinary simulations monthly empowering all staff to speak up for safety b, Change color of site marker from black to red c, Educate surgeons to be present for the timeout d, Implement process for surgical technician to hold the scalpel (not handing to surgeon) until timeout with all team members paying attention has been performed- JV Answer V -d, Implement process for A hospital is attempting to engage their board in their quality endeavors. Which is the best strategy to improve the board's involvement? a. Report all quality measures to the board. b, Align the quality measures with the hospital's strategic goals c. Focus only on measures that are tied to reimbursement d, Set only goals that can be attained- V Answer ¥ -b, Align the quality measures with the hospital's When an adverse event occurs with a patient: a. The patient should not be told about the event because of the possibility of legal action b. A root cause analysis should be completed and submitted to the Joint Commission One of the ‘fathers’ of the modern patient safety movement, Dr. Iucian Leape, has said that, “The single greatest impediment to error prevention in the medical industry is that we punish people for making mistakes." A movement to better manage human choices by limiting punishment to appropriate actions is known as: a. Restorative Justice b, The Triple Aim c, Just Culture d. Just Cause- V Answer ¥ -c, Just Culture The free, uninhibited flow of information that is open to the scrutiny of others is the definition of: a. High reliability b. Transparency c, Just Culture d. Quality care- V Answer ¥ -b. Transparency During daily rounding, a vice president observed a problem in a particular device that impacts delivery of care. This information was shared with other senior executive team members, and they have identified that this was a common issue. This resulted in replacing it with a different device in all affected areas. Which high reliability principle below was applied by the leaders of this organization? a. Resiliency b, Reluctance to accept simple explanations c. Deference to expertise d. Sensitivity to operations- V Answer V -d, Sensitivity to operations You have been asked to present an overview of safety events to the board of trustees. In order to best represent safety issues, you should; a. Highlight system-wide improvements that have been implemented in the past year b. Present cases of harm with contributing root causes and actions taken c, Display a graph of the numbers and types of safety events reported in the past year d, Lead an open discussion of board members’ safety concerns and recommendations- J Answer ¥ a a. Determine priorities based on pay-for-performance measurements b. Focus primarily on accreditation standards and requirements c. Develop a mechanism to gather input from a variety of sources d. Review the current literature to identify areas of frequent concern- V Answer ¥ -c. Develop a In a meeting with the CFO to determine return on investment (ROT) for multiple patient safety initiatives, which project is most likely to receive approval based on the determined ROT? a. Procurement of new beds with built-in alarms to reduce falls with an ROT of 0.9 b. Implementation of evidence-based guidelines to reduce the rate of catheter associated urinary tract infections with an ROT of 3.0 c. Implementation of Computerized Provider Order Entry to reduce the number of medication errors with an ROT of 1.0 d, Implementation of a sitter program, which has been shown to reduce falls and improve patient satisfaction with an ROT of 0.5- V Answer ¥ -b. Implementation of evidence-based guidelines to reduce Which of the following changes to operations would best highlight leadership's commitment to patient safety? a. Implementing quarterly town hall meetings to share organizational information b. The hospital executive reporting on patient safety at every board meeting c. Including an executive representative on all root cause analysis teams d, Executive leadership regularly participating in leadership rounds and daily safety briefings- V Answer v 
