Keeping Clients Safe: Error and Safety in Behavioral Health Settings _ ________________________________
KEEPING CLIENTS SAFE: ERROR AND SAFETY IN BEHAVIORAL HEALTH SETTINGS Self-Assessment Answers and Rationales
1. The correct answer is B. Rationale: From an HRO perspective, it would be a mistake to elimi- nate steps in a critical patient process, especially if the only objective is to save time for frontline staff members. Mistakes can certainly occur when necessary processes are overly simplified and should therefore be critically resisted and examined to determine how they affect the possibility of patient risk. 2. The correct answer is A. Rationale: From an RCA perspective, a critical element for success is the application of an RAC process to the exact context of a particular setting or practice. General RCA concepts might apply; however, specific factors will quickly need to be addressed in order for the new program to be effective. This customization allows for concepts to serve the precise needs of patients, providers, and leadership within a very specific healthcare environment.
3. The correct answer is B. Rationale: From a speaking-up perspective, Janet’s best course of action is to speak up to Mark. If this is a pattern of oversight, or becomes a pattern of oversight, an adverse patient event is likely to occur. Janet is naturally anxious about speaking up to her supervisor because she is a new employee on the unit; however, she has a duty to the patients and the hospital to be responsible and work to keep all patients safe. 4. The correct answer is C. Rationale: This revelation of suicidal ideation and planning is criti- cal. Ellen can act now to obtain authorization to speak with his wife and primary care provider, including them in creating a safer system of care for her new patient. Because the patient is new, it would be unwise to prematurely force him toward psychiatric admission—he might refuse, or potentially even more prematurely terminate with Ellen. Building rapport and creating a support team (his wife and primary care provider) establish the right clinical approach to keep her patient in therapy, which is the safest approach at this moment.
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