Quality improvement methodology and patient safety and systems-based practice concepts as tested on USMLE Step 3.
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- What does the acronym PDSA stand for in quality improvement?
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Plan, Do, Study, Act- In the PDSA cycle, what is the purpose of the 'Study' step?
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Analyze the data collected during the Do step to see whether the change had the intended effect- What is a sentinel event?
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An unexpected occurrence involving death or serious physical or psychological injury that is not related to the natural course of the patient's illness- What is a 'never event' in patient safety?
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A serious, largely preventable adverse event that should never occur, such as wrong-site surgery- What is a near miss (close call)?
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An error or hazard that did not reach the patient or did not result in harm- What is an active error?
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An error committed at the point of contact between a person and a system, with an immediate visible effect- What is a latent error?
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A hidden flaw in system design, organization, training, or policy that contributes to error but may remain dormant for a long time- What does the Swiss cheese model illustrate in patient safety?
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That harm occurs when holes (weaknesses) in multiple layers of a system's defenses line up, allowing an error to pass through- What is the main purpose of a root cause analysis?
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To identify underlying system-level causes of an adverse event rather than assigning blame to an individual- Is root cause analysis a reactive or proactive method?
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Reactive, it is performed after an adverse event or near miss has already occurred- What is Failure Mode and Effects Analysis (FMEA)?
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A proactive method used before an error occurs to identify steps in a process that are likely to fail and their potential effects- What is the defect rate goal targeted by Six Sigma methodology?
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No more than 3.4 defects per million opportunities- What is the primary focus of Lean methodology in process improvement?
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Eliminating waste and non-value-added steps in a process- What are the three components of the Donabedian model for evaluating quality of care?
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Structure, process, and outcome- In the Donabedian model, what does 'structure' refer to?
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The setting and resources in which care is delivered, such as staffing levels or equipment
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