- Begin by brainstorming types of health care organizations and groups of patients (e.g., geriatric patients requiring chronic care, pediatric patients admitted for acute care). Identify a particular type of setting and/or patient population to help you pinpoint your focus for the following step.
- Review the National Patient Safety Goals, the CDC’s NHSN Web site, and the information on patient safety concerns presented in the other Learning Resources. Select a specific patient safety risk (e.g., patient falls, medication reconciliation) to focus on for this assignment.
- Analyze the systems errors and/or human factors errors that should be considered with regard to this safety risk.
- Reflect on related insights that could be gained from high-reliability organizations. What approaches do these organizations use that might be applicable within a health care organization?
- Consider the strategies and tools (e.g., Six Sigma, Lean) that could be used to assess and reduce this particular risk.
- Evaluate the potential benefits of patient and family involvement and steps that could be taken to ensure that they are included in this endeavor.
- Briefly summarize the patient safety risk you have selected, and provide a rationale for why it deserves particular attention.
- Analyze the influence of systems errors and human factors errors with regard to this risk.
- Discuss related insights that could be gained from high-reliability organizations and how they might be applied within a health care organization.
- Propose strategies and tools for assessing and reducing risk related to this safety issue.
- Describe how patients and patients’ families can be involved in addressing this issue.
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