Healthcare_Errorproofing.PDF
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1 EP_1
2 Error Proofing in Healthcare EP_2
3 Institute of Medicine EP_3
4 EP_4
5 EP_5
6 EP_6
7 Yes No Yes Yes No No EP_7
8 3% = EP_8
9 a b EP_9
10 EP_10
11 EP_11
12 Solution Direction EP_12
13 EP_13
14 EP_14
15 (HGFM) (HGSP) EP_15
16 EP_16
17 HFMEA (Healthcare FMEA) J. DeRosier Hazard Scoring Matrix Decision Tree Analysis EP_17
18 Step 8: Floor Pain Team Prescribing Step 9: Floor Surgical Team Prescribing Step 10: Floor Initial Pain Assessment Step 12: Floor Uncontrolled Pain Step 11: Floor Continuation of Pain Care Step 13: Floor Oversedation Step 8: Floor APS Prescribing Step 14: Floor Transition to Oral Opiate Subprocess 8A: Pain team evaluation of home opiate medication on the floor Subprocess 8B: Pain team visits patient on the floor Subprocess 8C: Pain management regimen prescribed by the pain team on the floor Subprocess 8D: Pain team transitions the patient from PCA to oral opiates on the floor Subprocess 8E: Adjustments made by the pain team to the pain management regimen Failure Modes: 8A1: Omission of getting necessary information 8A2: Failure to obtain correct opiod history Failure Modes: 8B1: Omission of the pain team following the patient 8B2: Delay in patient care 8B3: Miscommunication between surgeon and the pain team 8B4: Overlooking potential adverse drug events Failure Modes: 8C1: Delay in care 8C2: Wrong provider paged 8C3: Select the wrong pain management practice 8C4: Wrong dose/drug prescribed 8C5: Duplicate orders 8C6: Orders missed EP_18
19 HFMEA Step 4 - Hazard Analysis Scoring Decision Tree Analysis Subprocess Failure Mode Severity Probability Haz Score Single Point Weakness? Existing Control Measure? Detectability Proceed? 8C Pain management regimen prescribed by the pain team on the floor 8C1 Delay in care N Y N 8C2 Wrong provider paged N N Y 8C3 Selecting the wrong pain management practice Y N N 8C4 Wrong dose/drug prescribed Y N N 8C5 Duplicate orders N N Y 8C6 Orders missed N N Y EP_19
20 EP_20
21 EP_21
22 EP_22
23 EP_23
24 EP_24
25 / / / / / / / / / EP_25
26 / / / / / / / / / / / EP_26
27 / / / / / / / EP_27
28 minutes EP_28
29 EP_29
30 EP_30
31 EP_31
32 EP_32
33 EP_33
34 : EP_34
35 HFMEA : HFMEA Step 4 - Hazard Analysis Failure Mode Severity Scoring Probability Haz Score Single Point Decision Tree Analysis Weakness? Existing Control Measure? Detectability Proceed? Potential Cause EP_35
36 (QGEPS) EP_36
37 EP_37
38 (Elimination) EP_38
39 : EP_39
40 Error Proofing in Healthcare EP_40
41 EP_41
42 (Replacement) EP_42
43 :.. EP_43
44 Error Proofing in Healthcare EP_44
45 Error Proofing in Healthcare EP_45
46 : EP_46
47 (Facilitation) EP_47
48 .. EP_48
49 Error Proofing in Healthcare EP_49
50 Error Proofing in Healthcare EP_50
51 Error Proofing in Healthcare EP_51
52 l EP_52
53 (Detection) EP_53
54 Error Proofing in Healthcare EP_54.
55 Error Proofing in Healthcare EP_55
56 Error Proofing in Healthcare EP_56
57 Error Proofing in Healthcare EP_57
58 . EP_58
59 (Mitigation) EP_59
60 Error Proofing in Healthcare EP_60..
61 Error Proofing in Healthcare EP_61
62 EP_62
63 EP_63
64 Personal Solution Space Solution N Solution 3 Solution 2 Solution N-1 Solution 1 P roblem EP_64
65 EP_65
66 EP_66
67 (7%) (7%) (20%) (2%) (5%) (23%) (2%) (5%) (23%) (1%) (7%) (7%) (26%) (48%) (14%) (5%) EP_67
68 (1) EP_68
69 (2) 1. : 2. : 3. : EP_69
70 (3) 1. : 2. : 3. : 4. : EP_70
71 (4) 5. : 6. : 7. : EP_71
72 (5) 1. : 2. : 3. : 4. : EP_72
73 (6) 1. : 2. : 3. : EP_73
74 : EP_74
75 Error Proofing in Healthcare EP_75
76 EP_76
77 1. RPN minutes EP_77
78 Error Proofing in Healthcare EP_78 : :
79 Solution Priority Number (SPN) EP_79
80 SPN (Solution Priority Number) 1 ( ) 3 ( ) 1 () 3 () 1 ( ) 3 ( ) EP_80
81 3 2 1 : EP_81
82 3 2 1 : : : EP_82
83 3 2 1 : : : EP_83
84 Error Proofing in Healthcare EP_84 :
85 20 minutes EP_85
86 : No SPN EP_86
87 Error Proofing in Healthcare EP_87
88 Error Proofing in Healthcare EP_88
89 EP_89
90 EP_90
91 EP_91
92 EP_92
93 SSM Health Care EP_93
94 Baptist Hospital EP_94
95 Saint Luke's Hospital EP_95
96 EP_96
97 EP_97
98 Linda T. Kohn et al. ed. (2000): To Err is Human: Building a Safer Health System, National Academy Press. (1984):,, Vol.14, No.2, pp Timothy G. Clapp A. Blanton Godfrey 2005 :,, Vol.35, No.3, pp Terninko, John, Alla Zusman, and Boris Zlotin (1998): Systematic Innovation: An Introduction to TRIZ, CRC Press LLC. EP_98
99 QC (1979): QC 1985, Vol.15, No.1, pp DeRosier, Joseph et al (2002): Using Health Care Failure Mode and Effect Analysis, The Joint Commission Journal of Quality Improvement, Vol. 28, No. 5, pp :,, Vol.36, No.1, pp EP_99
100 Sister Mary Jean Ryan and William P. Thompson, CQI and the Renovation of an American Health Care System A Culture Under Construction, ASQ Quality Press, Al Stubblefield, The Baptist Health Care Journey to Excellence Creating a Culture that WOWs!, John Wiley & Sons, Inc., EP_100
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