CPHQ Patient Safety Principles 5 — Questions and Answers
Question 1: Which patient safety initiative by WHO requires a surgical team pause immediately before skin incision to confirm patient, procedure, and site?
- Time-out (Correct answer)
- Sign-in
- Sign-out
- Debrief
Correct answer: Time-out
The WHO Surgical Safety Checklist 'time-out' occurs immediately before incision and confirms patient identity, site, procedure, and team readiness.
Question 2: A hospital's incident reporting rate drops by 40% after disciplinary action is taken against a nurse who reported a medication error. This outcome illustrates the risk of:
- Punitive reporting culture (Correct answer)
- Alert fatigue
- Over-reporting bias
- Hindsight bias
Correct answer: Punitive reporting culture
A punitive reporting culture deters staff from reporting errors, reducing the data needed to identify and fix systemic problems.
Question 3: Which model categorizes care as having structure, process, and outcome components to evaluate quality and safety?
- Lean Model
- Donabedian Model (Correct answer)
- IHI Triple Aim
- PDSA Cycle
Correct answer: Donabedian Model
Avedis Donabedian's model evaluates healthcare quality through three dimensions: structure (resources), process (care delivery), and outcomes (results).
Question 4: Which strategy is MOST effective at preventing look-alike/sound-alike medication errors at the point of dispensing?
- Tall man lettering on drug labels (Correct answer)
- Limiting formulary choices
- Color-coding all medications
- Requiring verbal orders for high-risk drugs
Correct answer: Tall man lettering on drug labels
Tall man lettering (e.g., vinBLAStine vs. vinCRIStine) highlights distinguishing letters to differentiate look-alike/sound-alike drug names.
Question 5: A healthcare organization wants to monitor patient safety proactively. Which measure is considered a 'leading' indicator?
- Hospital-acquired infection rate
- Mortality rate
- Staff safety culture survey scores (Correct answer)
- Average length of stay
Correct answer: Staff safety culture survey scores
Safety culture survey scores are leading indicators because they measure conditions that predict future safety performance before harm occurs.
Question 6: During a root cause analysis, the team asks 'Why?' repeatedly until a systemic root cause is identified. This technique is known as:
- Fishbone analysis
- 5 Whys (Correct answer)
- Failure mode analysis
- Pareto analysis
Correct answer: 5 Whys
The 5 Whys technique iteratively asks 'Why did this happen?' to drill past symptoms to underlying systemic causes.
Question 7: Which element of high-reliability organization (HRO) theory involves staff at all levels feeling empowered to stop a process when they detect a safety concern?
- Sensitivity to operations
- Deference to expertise (Correct answer)
- Preoccupation with failure
- Reluctance to simplify
Correct answer: Deference to expertise
Deference to expertise means that in HROs, decision-making authority shifts to the person with the most relevant knowledge, regardless of hierarchy.
CPHQ Patient Safety Principles 5
Which patient safety initiative by WHO requires a surgical team pause immediately before skin incision to confirm patient, procedure, and site?