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ForwardQIPS: Assessing and Mitigating Risks to Safe Care and Operations: The Role of Proactive Risk Assessments and Retrospective Cause Analysis
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While many clinicians and administrators have a broad understanding of risk mitigation and patient safety improvement tools, practical experience is often lacking. This course provides concrete information on the manner in which Root Cause Analysis (RCA), Root Cause Analysis and Action (RCA2) and Failure Mode Effects Analysis (FMEA) are utilized in the prevention of medical errors. Attention will be given to identifying system errors, recording adverse events, and determining which events warrant the use of a specific tool. The course presentation outlines steps necessary to conduct an effective RCA, with emphasis placed on actions that arise from the RCA process through the root cause analysis and action (or RCA2) rubric. In addition, the course provides for hands-on practice in the implementation of patient safety and risk mitigation tools and concepts into clinical practice and medical education.
Successful Completion
To successfully complete this activity, the required evaluation must be completed no later than Monday, April 19, 2021. Thereafter, the evaluation will no longer be available and credits will not be issued. No refunds will be offered for failure to complete the required evaluation by the stated deadline.
Target Audience
The target audience for this educational activity are physicians, PAs, nurses, and those working in radiology and neurocritical care.
Learning Objectives
Following this educational activity, learners will be able to:
- Differentiate the role / value of proactive vs. reactive cause analysis for the reduction of patient harm.
- Describe the key steps in conducting a cause analysis to identify the root causes in the provided scenario for the purpose of improvement.
- Apply Safety I and Safety II theory when considering and conducting risk mitigation.
- Discuss the value of proactive risk assessments in identifying and prioritizing mitigation efforts that result in safer care and operations.
Commercial/In-Kind Support
This educational activity received no commercial or in-kind support.
Online Meeting
This educational activity will be held via zoom. Information for accessing the activity will be sent via email.
Conflict of interest
Thomas Jefferson University endorses the Standards for Integrity and Independence in Accredited Continuing Education and the policies that supplement the Standards.
All planners, faculty, and others in control of educational content are required to disclose any relevant financial relationships with ACCME defined ineligible companies within the past 24 months. Any conflicts of interests have been mitigated prior to this educational activity.
All faculty/presenters/authors at Thomas Jefferson University sponsored events are required to disclose whether or not their content contains information of commercial products/devices that are unlabeled for use or investigational uses of products not yet approved. Product(s) is/are not included in the labeling approved by the U.S. FDA for the treatment of disease(s).
Such disclosures will be available prior to the start of the activity. Jefferson conflict of interest mitigation process may result in changes to the program agenda.
Exception: According to the Standards, it is not required to identify, mitigate, or disclose relevant financial relationships for any of the following activities:
- Accredited education that is non-clinical, such as leadership or communication skills training.
- Accredited education where the learner group is in control of content, such as a spontaneous case conversation among peers.
- Accredited self-directed education where the learner controls their educational goals and reports on changes that resulted, such as learning from teaching, remediation, or a personal development plan.
Planning Committee
Mary Reich Cooper, MD JD-Activity Director
Ellen Guarnieri, RN, MHSA, CPHQ, FACHE
Richard Hass, PhD
Maureen Frye, MSN, ANP-BC, CRNP, CPPS, CPHQ
Faculty
Ellen Guarnieri, RN, MHSA, CPHQ, FACHE
Maureen Frye, MSN, ANP-BC, CRNP, CPPS, CPHQ
Off‐label/Investigational Use
This activity does not contain information of commercial products/devices that are unlabeled for use or investigational uses of products not yet approved.
Content Disclaimer
The views expressed in this activity are those of the faculty. It should not be inferred or assumed that they are expressing the views of any manufacturer of pharmaceuticals or devices or Thomas Jefferson University.
It should be noted that the recommendations made herein with regard to the use of therapeutic agents, varying disease states, and assessments of risk, are based upon a combination of clinical trials, current guidelines, and the clinical practice experience of the participating presenters. The drug selection and dosage information presented in this activity are believed to be accurate. However, participants are urged to consult all available data on products and procedures before using them in clinical practice.
In support of improving patient care, Thomas Jefferson University is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Credit Designation
Physicians: This educational activity is designated for a maximum of 3.5 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Nurses: This activity awards 3.5 nursing contact hours.
Other Healthcare Professionals: This educational activity is designated for 3.5 AMA PRA Category 1 Credits™. Participants should claim only the credit commensurate with the extent of their participation in the activity.
Credit count includes .25 credit for completion of the required online evaluation.
Available Credit
- 3.50 AMA PRA Category 1 Credit™
- 3.50 Attendance
- 3.50 CNE