Patient Safety, Quality Improvement and Professionalism/Medical Ethics
Patient Safety
Understand the Swiss cheese model of error, the difference between active and latent errors, and the role of human factors. Know the WHO surgical safety checklist and the principles of the time-out. Understand the reporting of critical incidents and the concept of a just culture.
Quality Improvement
Know the Model for Improvement (Plan-Do-Study-Act), the use of control charts, and the importance of measuring outcomes and processes. Understand the role of audit and the difference between quality assurance and quality improvement.
Ethics and Professionalism
Know the four principles of biomedical ethics: autonomy, beneficence, non-maleficence, and justice. Understand informed consent, capacity, and the management of patients who refuse treatment. Know the concept of futility and the role of advance directives. Understand confidentiality and the duty to report impaired colleagues.
Traps
Questions often test the principle that applies to a scenario (e.g., respecting a competent patient's refusal reflects autonomy) and the difference between capacity and competence. Another trap is the belief that a family member can consent for a competent adult; they cannot. Also know that the checklist is not a substitute for clinical judgment.
Worked Example
A competent adult Jehovah's Witness refuses blood transfusion before elective surgery. Respect autonomy, document the refusal, and plan alternatives such as iron therapy, erythropoietin, and cell salvage. Do not proceed with transfusion against the patient's wishes.