Patient Safety and Quality Improvement
Core concepts
Patient safety questions test systems thinking: most errors arise from flawed processes, not bad individuals. Know the language of quality improvement - structure, process, outcome measures; Plan-Do-Study-Act cycles; run charts and control charts; root cause analysis for severe events; and incident reporting as a blame-free learning tool. Understand common harm categories (medication errors, healthcare-associated infection, falls, pressure injuries, wrong-site procedures, handover failures) and standard mitigations such as checklists, time-outs, barcode medication administration, and hand-hygiene bundles.
Traps
Options that punish an individual for a systems problem are usually wrong; so are options that rely on "reminding staff to be careful." Distinguish quality improvement (iterative, local, data-driven) from audit (measuring against a standard) and from research (generalizable new knowledge). Watch for questions where the best first step is to report the incident or disclose to the patient, not to investigate quietly.
Rule of thumb
Fix the system, not the person. For any improvement question, choose the option that measures a baseline, makes a small testable change, and re-measures.
Worked example
Repeated wrong-patient medication near-misses on a ward: the strongest intervention is a system change such as barcode scanning with two-identifier verification, not an email reminding staff to double-check. Measure error rates before and after using a run chart.