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IHP 315: Root Cause Analysis and Patient Safety Strategies

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IHP 315: Root Cause Analysis and Patient Safety Strategies
 

 
IHP 315 Milestone One Guidelines and Rubric
For your first step in developing your error analysis and recommendations paper, you will select one of the case studies from the Final Project Case Studies
document to be the focus of your entire project. You will then complete a root cause analysis and recommend appropriate patient safety strategies. Remember,
this is your first draft. You will have an opportunity to incorporate suggestions from your instructor and course content in later modules prior to submitting your
final version in Module Seven.
In this first milestone, the following critical elements must be addressed:
I. Root Cause Analysis (RCA): In this section, you will provide an overview of the details in the provided case study that led to adverse patient outcomes.
This overview will be in the form of a flowchart, which you will then use to help you analyze the medical error. Specifically, you should include the
following:
A. Timeline: Using a flowchart, summarize the events, processes, and staff involved in the timeline of events that led to the medical error.
B. Factors: Based on your flowchart, use a modified root cause analysis to do the following:
i. Identify two contributing factors that led to the medical error
ii. Identify one causal factor that led to the medical error
Hint: For help with the RCA, refer back to your work relating to the AHRQ website in Module One.
II. Patient Safety Strategies: In this section, you will use the factors you identified to recommend a measurable evidence-based patient safety
improvement strategy. Specifically, you should include the following:
A. Recommendation: Based on the contributing factors or causal factor that you identified, recommend an evidence-based patientsafety
improvement strategy. What role would patients and families have in your recommendation?
B. Measurement: How will the strategy be measured so that medicalstaff can determine whether the strategy led to improved patient safety? In
other words, what will the primary measure be? What types of data should be collected?
Guidelines for Submission: Submit an APA referenced and formatted paper that is 3 to 4 pages in length, excluding the cover page and reference list. This will be
a Microsoft Word document with double spacing, 12 point Times New Roman font, and one-inch margins.
Rubric
Critical Elements Proficient (100%) Needs Improvement (70%) Not Evident (0%) Value
Root Cause Analysis:
Timeline
Using a flowchart, summarizes events,
processes, and staff involved in timeline of
events that led to medical error, with few
gaps in the details
Summarizes events, processes, and staff
involved in timeline of events that led to
medical error but without using a flowchart
or with gaps in detail
Does not summarize events, processes, and
staff involved in timeline of events that led
to medical error
25
Root Cause Analysis:
Factors
Based on flowchart, identifies at least two
contributing factors and one causal factor
that led to the medical error, using a
modified root cause analysis
Identifies two contributing factors and one
causal factor that led to the medical error
but not based on flowchart, without using a
modified root cause analysis, or with gaps
in accuracy or logic
Does not identify two contributing factors
and one causal factor that led to the
medical error
25
Patient Safety
Strategies:
Recommendation
Recommends an appropriate evidencebased patient safety improvement strategy
based on the identified factors and
describes role of patients and families in
recommendation
Recommends a patient safety improvement
strategy and describes role of patients and
families in recommendation but strategy is
not appropriate based on the identified
factors or response has gaps in detail
Does not recommend a patient safety
improvement strategy
20
Patient Safety
Strategies:
Measurement
Explains how the strategy will be measured
so that medical staff can determine
whether the strategy led to improved
patient safety
Explains how the strategy will be measured
so that medical staff can determine
whether the strategy led to improved
patient safety, but with gaps in clarity or
detail
Does not explain how the strategy will be
measured so that medical staff can
determine whether the strategy led to
improved patient safety
20
Articulation of
Response
Submission has no major errors related to
citations, grammar, spelling, syntax, or
organization
Submission has major errors relatedto
citations, grammar, spelling, syntax, or
organization that negatively impact
readability and articulation of main ideas
Submission has critical errors related to
citations, grammar, spelling, syntax, or
organization that prevent understanding of
ideas
10
Total 100

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