Patient Safety and Quality Improvement: Developing a Systems View

1. A system is best described as

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A discipline for seeing wholes

A set of interrelated or interacting parts any one of which, if changed, can impact overall outcome

2. An example of reductionistic thinking is:

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Telling a nurse to be more careful after making a medication error

Investigating all aspects of the medication use system when a medication error occurs

Improving staffing in the pharmacy after a nurse makes a medication error

Improving the computerized order entry system for prescribers after a nurse makes a medication error

3. An example of proactive systems thinking within a healthcare setting is (select all that apply):

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reviewing voluntarily reported errors

reviewing voluntarily reported errors with a transdisciplinary group of people

review hazards reported in the Institute for Safe Medication Practices (ISMP)

Lesson 4 Quiz Quiz, 10 questions

review hazards reported by the Federal Drug Administration (FDA)

4. The performance of a system is improved when the performance of each part is maximized.

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True

False

5. The best example of holistic thinking is:

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Telling a nurse to be more careful after making a medication error.

Investigating all aspects of the medication use system when a medication error occurs.

Telling a nurse to remember to do the 5 rights (right patient, right medication, right dose, right route, right time) after making a medication error.

Telling a nurse to use barcode medication administration after making a medication error.

6. A flaw lying dormant in a system that has not yet contributed to an error is a:

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Active error

Hazard

Latent error

Execution error

7. Solution solves the problem at hand without decreasing chance of error recurrence is an example of:

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First order processing

Second order processing

8. Identifying and resolving the many upstream processes that led to an error is an example of:

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First order processing

Second order processing

9. According to Russel Ackoff, problems are most likely best resolved at the point in which they appear in the system.

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True

False

10. When healthcare staff have less time available than what is needed to do their work the following symptoms appear (select all that apply):

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Feeling overwhelmed

Less errors

Decreased preventable harm

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Dissatisfaction

Lack of teamwork

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