Unit 1 Exam material

Many healthcare organizations are within what part of the Safety Culture Ladder?

(lower End) -Pathological -Reactive -Calculative

There are 3 categories of Deviant Behavior, what are they?

- Human Error: unintentional and a mistake - At-Risk: Behavior than increases risk, assumption - Reckless: Conscious choice, doing it on purpose

HROs have an intense focus on ___________________&____________________ errors and their ______________is what leads to that.

- identifying and preventing errors -culture

What are some things that may be an example of disruptive behavior?

- someone who is unwilling to accept different ways -verbal outbursts -lack of respect for others -poor communication -point out others' flaws -passive aggressive

What does the culture look like in HROs?

-ALL employees have collective mindfulness that they are in a high risk setting and their actions can lead to high risk error -Eagar to report & find mistakes before they become problematic -commitment to address safety concerns (leadership structure supports the framework for a HRO)

The 3 Main causes of error are....

-Assumption -communication -perception

Who was Kimberly Hiatt? And what happened to her?

-Kimberly was a Seattle Nurse who gave 10x the dose of medication to a baby and immediately took action to alert her team about it. -She was suspended the day of and then fired a few weeks later -She then killed herself

What is safety?

-Minimizes risk of harm to patients and providers -minimizes risk of injury or illness

When a person believes the error did not occur due to a skill or trait they have, this is known as ___________________. This leads to ______________ behavior.

-Resilient Near Miss -more risky behavior

Explain the PDSA process in Healthcare when it comes to errors...

-an error occurs -that error is reported via incident learning system -causes are identified (using various tools such as fishbone diagram) -Plan is made -Plan enters PDSA cycle to be studied and evaluated

As you climb up the Safety Culture Ladder (pathological to generative), what happens?

-an increase in information sharing -increasing trust and accountability

What is culture?

-beliefs of a certain group -what comes nature to someone -defined on different levels: values, food/drinks, art, tools, techniques, skills, traditions or rituals

What is safety culture NOT?

-blame culture -environment of maintaining the "status quo"

Why are effects unknown when it comes to underdosing and overdosing?

-can take a while for side effects to show up (for overdosing) -different sites respond diff. to radiation

severity of incidents _______________ overtime while the number of errors reported ______________________.

-decrease -increases

An overhaul of organizational structure or paradigm shift requires:

-dedicated people (overseeing projects to facilitate change) -continuous support of new culture -turn away from the traditional "punishment" or "ridicule" from making errors -a system of improvement cycles

Physical impact on patients can be ___________, ______________, and _____________.

-direct, immediate, and known -obvious something happened

What are some reasons for high rates of burnout in RTs?

-emotional impact -stress of job -high expectations

Active error means...

-errors that occur while working with the system -potential for errors are more obvious

Signs and Symptoms of Burnout

-exhaustion -headaches -fatigue -gastrointestinal problems -insomnia

What are some barriers to disclosure?

-fear of losing job -fear of facing consequences -embarassment -dont want to break level of trust -rationalization

Why do people most often sue?

-for answers -not for money

For what type of situation would Autocratic leadership be best? Why?

-for lazy and chaotic people/environment that needs organization

For what type of situation would Laissez-faire leadership be best? Why?

-for people who are innovative and have creative thinking

For what type of situation would bureaucratic leadership be best? Why?

-for someone who likes to follow the rules and for a culture of safety

Systematic error means...

-given the same condition, the error is very likely to occur again

Increased culture of safety causes a ________________ number of reported errors and __________________________.

-higher -near misses

What are some medical accelerator hazards?

-incorrect dose -incorrect area of dose delivery -machine -incorrect beam -general hazards

What factors influence clinical practice?

-insituitional content -organizational and Management Factors -work environment factors -team factors -ind. factors -task/ technology -patient factors

The benefit of working with a transactional leader is....

-its all black and white (minimizing variation) -you know what is right or wrong, what you should or should not do -no grey area

Some people will remember an error as if it _____________________________, for years. This is more common with __________severe errors.

-just happened -more severe errors

Healthcare workers are generally more likely to engage in improvement efforts if:

-leaders are present on floor working with them -leader is known for making safety a priority -leader provides time for employees to be involved & work on initiatives

Learning can occur in both _________________ & __________________ incidents.

-major -minor

Impact of Errors can me both _______________ and ________________

-major incidents (devastating, news making - overdose by a lot) -minor incidents (ex. no bolus during treatment - result in overdose or underdose)

How does the Brigham model work?

-makes the employee aware of how the action was perceived -helps employee understand the impact of their actions (despite intent)

What is included in data collection and incident chronology?-

-medical records -record-and-verify system -interviews with staff -Identify the how and why

What are some qualities of a Transformational leader?

-motivating -inspiring -takes time to generate: followers have strong trust, admiration, loyalty, and respect with them -considers the needs of followers -excite followers to strive beyond the norm -focus is on adaptation and innovation

What is the leadership's role in a culture of safety?

-organizational Culture shift

What should you expect when communicating your errors or reporting errors?

-practice conversation in advance -resist blaming -going to feel uncomfortable -have 2nd healthcare prof. present to help colaberate

Latent error means...

-problems are hidden until the conditions are just right

For what type of situation would participative leadership be best? Why?

-process or environment that needs improvement

When driving change what behaviors occur in improvement cycles?

-quick fixing -initiating -conforming -expediting -enhancing

How can we manage human error?

-reinforce what the process or procedures are -ensure awareness and understanding of what went wrong

What are the best practices to drive safety in healthcare?

-relying on Infrormation technology -Evidence based tools -simulation and training -performance reporting -medication safety

How do we facilitate a culture of safety in radiation oncology?

-reporting system (good catch/near miss) -chart rounds -safety rounds: leader speaks to employees directly (quarterly or monthly) -huddles (improving communication) -peer review (MDs/Dosimetrists/physicists) sometimes RTs -workload optimization (min of 2 RTs/machine) -Time-out (checklist, verify critical info)

How can we manage "At-risk" behaviors?

-requires coaching to increase situational awareness (best done in the moment to make people realize what they are doing wrong) -align incentives to appropriate behavior

What are some ways that leadership and management can get the individual engaged in safety?

-reward system (motivate people for change) -talk openly about it -making it a topic of conversation and on the forefront of the leaders -empower the ind. to make a change by coming up with ideas for change within org.

What are some qualities of a Transactional leader?

-rewards achievement (feedback, praise -monitors deviation (watch for someone not adhering to the goals they are trying to obtain) -achievement of short term goals -favors structure, policies and procedures -thrives on rules an "correct way" to do things

PDSA cycle

-scientific method of making teams produce better quality of products

What are some qualities of a leader?

-someone who listens (good communicator) -honest and shows respect -open to feedback -willing to grow -strive to improve -responsible

Sporadic error means...

-the same error is unlikely to occur again in the same process step or set of conditions

What are some KEY infrastructures of aviation safety?

-training focused on mitigating secondary incidents resulting from errors (everyone learns from errors and prevents them from happening again) -policies and procedures that enforce safe operations -flight recorders to monitor key flight parameters (for training purposes or investigations)

Which type of leadership do you think is best when trying to implement a culture shift?

-transformational leadership is better in the beginning of the change process (getting people onboard with the change) -There needs to be balance though and things may need to get done quicker "short term goals" and in this case transactional leaders would be best

In error reporting, 1st :___________________________________.

-understand what happened and that it actually happened

Psychological safety means...

-when someone feels safe voicing their opinions/concerns

What are the benefits of working with a transformational leader?

-you feel valued as a person -creates trust and respect -feel cared about as a person -makes you want to strive beyond the norm

What are the 4 Nature of Errors?

1. Active 2. Latent 3. Sporadic 4. Systematic

What are 2 main industries that meet requirements of of High Reliablity Organizations (HROs)?

1. Aviation 2. Nuclear Power

What are 3 stages of Burnout?

1. Emotional Exaustion 2. Depersonalization 3. Decreases sense of personal accomplishment

What are the 3 parts to the NRC of the Culture of Safetyr?

1. Leadership 2. Management 3. Individual

What are the 5 parts of the Safety Culture Ladder?

1. Pathological 2. Reactive 3. Calculative 4. Proactive 5. Generative

What are the 3 parts of the Foundation of HROs?

1. Prevention 2. Identification and Mitigation 3. Redesign (reduce or eliminate risk of error occuring)

What are the 5 Categories of Improvement Behavior?

1. Quick Fixing 2. Initiating 3. Conforming 4. Expediting 5. Enhancing

3 different Incident Learning Systems (what are they?)

1. RO-ILS - The Radiation Oncology-Incident Learning System is a web based incident reporting system that provides a global mechanism for collaborative learning within radiation oncology 2. SAFRON - Safety in Radiation Oncology is an integrated voluntary reporting and learning system in radiotherapy and radionuclide therapy incidents and near misses. 3. ROSEIS - is the "Radiation Oncology Safety Education and Information System". It is a voluntary web-based platform designed for use as an individual clinic reporting and learning tool and also as a platform to exchange or share information with the wider radiotherapy community.

AHRQ did a study and found 7 different variables that were important to make a cultural shift. What are the 4 biggest ones?

1. Reporting error; free of blame 2. Open disscusion of errors 3. education and training to prevent or fix errors and to explain why the change is important 4. system redesign/change

What are the 2 types of Leadership?

1. Transactional Leadership 2. Transformational Leadership

What two things could be the reasoning behind reckless behaviors?

1. behavior issue (is it repetitive?) or burnout? 2. System or Process issue: is the system set up to fail? what isn't preventing error?

What are 2 examples of safety culture in the medical field?

1. work to improve and maintain safe patient care practices 2. continuous improvement (always evaluating the situation)

Incidence of overexposure to radiation is _______ per _______________ treatment courses.

15 per 10,000

ASTRO's new accreditation program has a total of _____________ standards.

16

What members of the organization does a culture shift require participation from?

ALL members of the organization (top down, bottom up)

AHRQ

Agency for Healthcare Research and Quality

AAPM

American Association of Physicists in Medicine

ASTRO

American Society for Therapeutic Radiology and Oncology

ASRT

American Society of Radiologic Technologists

Which process of the psychology of error is when a person carefully considers all the info she has infront of her, take their time making a decision and requires lots of resources, and rational judgement is made using all the information?

Analytical process

This type of bias is when someone shapes their decision making based on prior expectations.

Ascertainment bias

What type of leader likes to get things done, is very direct and clear on directions, employees do not participate in decision making, and is result driven?

Autocratic Leadership

What type of leadership is authoritarian, a dictator and has close supervision?

Autocratic Leadership

What is essentially the blueprint that the healthcare system is trying to model after?

Aviation Industry Model

What model is used to address the disruptive individuals?

Brigham model

What type of leadership would fit in a radiation oncology department best and why?

Bureaucratic (for structure, but may need to be flexible because every patient is different) and participative (for outdated policies to have opportunity for growth)

What type of leader believes rules are the law, no deviating from the law, typically will lead to a high level of efficiency and have function in roles?

Bureaucratic Leadership

What type of leadership is most effective at creating a culture of safety?

Bureaucratic and Participative

Which of the 5 Steps of the Safety Culture Ladder is where we have systems in place to manage all hazards?

Calculative (middle step, #3)

What type of bias is when someone has the tendendency to believe, seek out, and interpret informationthat supports one's own preconceptions? (seeking information that confirms)

Confirmation bias

This improvement behavior is in compliance with standard procedures in a system free of defects.

Conforming

What usually occurs when the outcome is undesirable.

Counterfactual Thinking

The tendency of peope to create alternative, imaginative outcomes after the actual outcome is known, is the.....

Counterfactural thinking

Of the 16, the seventh standard of particular interest of ASTRO's new accreditation program is -_____________________

Culture of Safety

If a defect occurs, you have ___________________ or _________________ behaviors and if a defect doesn't occur, you have ___________________, ____________________, or __________________ behaviors.

Defect: quick fixing or initiating behaviors No Defect: conforming, expediting, or enhancing

Culture of Safety is ______________________ responsibility

EVERYONE's

This improvement behavior is the most desirable behavior and has efforts to make system improvements.

Enhancing

This improvement behavior does NOT motivate change and is non-compliant with standard procedures in a system free of defects. (taking shortcuts to go faster)

Epediting

_______________ is an unintended act, either of omission or commission, or an act.

Error

When someone assumes something is right without rechecking or going through proper protocol, this is an example of what behavior?

Expediting; he assumed

T/F: Health care settings are considered a HRO.

False

T/F: Its best to use the system of "divide and conquer" when 2 RTs are working together.

False; avoid doing that

T/F: A disruptive individual can impact patient safety positively.

False; negatively

The __________________________ is how information is presented and how a question is framed and can impact future decisions.

Framing Effect

In which of the 5 Steps of the Safety Culture Ladder, is the step where collective problem solving creates ownership of processes and everyone take ownership of their actions? (Step of chronic unease)

Generative (#5)

What type of organizations are very predictable, have effective outcomes (low error rates), and must be in a high risk setting?

HROs

HRO

High Reliability Organization

The tendency of the treatment team/patient/family to choose more treatment and interentions rather than supportive care (involving intrinsic preference for action) is the ___________________________ bias.

Intervention

Which process of the psychology of error is where: -mental short cuts are used to make quick judgement, -thinking is not done deliberately, and -is associated with first impressions -leaves more room for error

Intuitive Process -triggers unconscious bias

This type of leadership assumes all employees are motivated (independently), need little to no supervision, are given the task and given resources, but have the freedom to accomplish the task without direction?

Laissez-faire Leadership

How do each of the 3 below contribute to culture of safety? 1. Leaders 2. Staff 3. Departments

Leaders: develop vision and empower others Staff: do jobs effectively and continue to look for more effective ways Departments: dev. systems to identify problems and explore solutions collaboratively

_____________________is the most important component to accomplishing change for a culture of safety.

Leadership

How do the 3 parts of culture of safety all work together? And what does top down, bottom up mean with the triangle?

Leadership needs to decide that safety is important and that they need a culture of safety and do things to communicate and generate this change. Meanwhile management is training the employees (individuals) who are the ones who need to impliment and believe that safety in their work environment is important.

How can we manage reckless behaviors?

MAIN THING--> requires remedial or punitive responses depending on behavior (or the system) before acting

Of the 5 best practices to drive safety in healthcare, which one is not a part of the Aviation Industry Model?

Medication safety

leadership, management and the individual in their organization all have to be aligned in their policies and practices and procedures to develope a culture of safety.

NRC (Nuclear Regulatory Commission)

Does obtaining consent for a treatment protect healthcare workers from legal liablility regarding errors?

No, it protects from complications that are thought to possibly happen.

Do you feel Kimberly should have been fired for her misadministration of the medication?

No, she didn't intent do and owned up to her mistakes. Now the hospital has lost a very valuable member due to one unintentional mistake.

NRC

Nuclear Regulatory Commission: Culture of Safety

How do we find balance beween the groups to provide better patient care?

PDSA cycles

What type of leader includes group contribution, organizational effort is ephasized, employees involved in decision making, and overall works well as a team?

Participative leadership

Which of the 5 Steps of the Safety Culture Ladder is where people only think of themselves and think "it doesn't matter unless I'm caught"?

Pathological level

What is reliablility in healthcare?

Patients receive the: -appropriate tests -appropriate medication -appropriate information AT THE RIGHT TIME!!!! all together = improved outcomes and quality care

Which of the 5 Steps of the Safety Culture Ladder is where safety leadership and values drive continuous improvement? Organization is trying to make practices safer for patients.

Proactive (#4)

For Fredrick Stein, what was forgotten during treatments?

QA was never completed on treatment plan and side effects were significantly worse than expected

This improvement behavior has detection and correction of defects and fixes what is wrong, but moves on right afterward.

Quick fixing

Which of the 5 categories of improvement behavior increase the risk of error to occur?

Quick fixing and Expediting

Radiation to the spine could cause _____________________________.

Radiation Myelopathy (which can lead to paralyzation)

Which of the 5 Steps of the Safety Culture Ladder is where safety is important but really only becomes a focus when something happens and then a few months later people forget about it? Safety is not a main focus. and same error happens again.

Reactive (#2)

For procedural steps omitted (expediting behavior), of the 3 categories of behavior, what would this be an example of?

Reckless: they know what the steps are supposed to be At-risk: assuming the skipped steps wont cause harm

Addressing the system (after reckless behavior) can reduce _______________________ and enhance _______________.

Reduce risk of future errors Enhance safety

What are some professional organizations that respond with statements regarding patient safety?

SROA ASRT AAPM ASTRO

Is autocratic leadership something that is effective for a short period or long period of time?

Short, people don't like to be told what to do all the time.

SROA

Society of Radiation Oncology Administrators

Culture of Safety is considered to be a ________________________________ in Radiation Therapy.

Standard of Practice

If you make changes in the PDSA, you need to __________________.

Start over from the top

What are a majority of errors in reckless behaviors caused by?

System or Process issues

omission

The act of leaving out or neglecting

On what part of the Safety Culture Ladder does Blame Culture tend to take place?

The lower end (pathological and reactive)

PDSA PDCA are __________________ and stand for...

They are improvement cycles and are basically the same thing. PDSA: Plan-Do-Study-Act PDCA: Plan-Do-Check-Act

What is the biggest difference between transactional and transformational leadership?

Transactional focuses on the WHAT and transformational focuses on the WHY.

Common goal for radiation oncology....

Treat patients safely and effectively

T/F: People naturally do PDSA cycles on a day to day basis and don't even realize it.

True

T/F: Unintended outcomes can occur even when an error did not occur.

True; (ex. radiation necrosis, radiation myelopathy)

_____________________ & _________________ need to be clearly communicated for individuals to understand the big picture and to be motivated to help and be a part of change.

Vision & Strategy

When a mistake is made and a person feels like an error did not occur due to luck or fate, this is an example of...

Vulnerable Near Miss

The focus is on ______________, not WHO did what to contribute

WHAT went wrong

Ask ______________ until you get to the fundamental that can be corrected.

WHY

What is an example of Normalization of deviance?

When you take a short cut, time and time again, and no bad results happen, it becomes normal behavior. Often resulting in errror to occur.

-process/procedure incorrect -procedural steps omitted -training missing depends on situation

Which of the root causes here could be due to expediting behaviors?

What is blame culture?

a more punitive approach involving discovering who is at fault rather than why defenses failed; ineffective

Saftey Culture describes an environment that healthcare professionals have both the __________________and _________________ that safety is a priority.

ability and the perception

ASTRO has initiated a new accreditation program aimed at improving ______________of radiation therapy practices

accountability

potential errors are more obvious for what nature of error?

active

The first principle of incident investigation is understanding errors can be ______________ or ________________

active or latent

Which process of the psychology of error is considered "central thinking" or "slow thinking"?

analytical process

An ________________ bias gives weight and reliance on intitial information and impressions.

anchoring bias

Giving weight and reliance on intitial information and imprssions is the ______________________bias.

anchoring bias

The 2nd principle of incident investigation is choosing ____________________________ for the investigation.

appropriate team members

commission

authorization; act of giving authority to an individual

What type of bias is when someone has the tendency to overestimate the occurence of events that are known to the individual? (events are more "available" depending on how unusual or emotionally charged they are)

availability bias ex. once you have one patient that comes in having a heart attack, all the patients are going in for a heart attack

Errors can disrupt the team _________________.

balance

Punishing people for mistakes does not lead to __________________________

better safety

Many healthcare organizations fall in the same levels as _______________________ on the Safety Culture Ladder. (and a place you don't want to be in within Radiation Therapy)

blame culture

Errors can contribute to __________________.

burnout

Radiation therapists that are experiencing _____________________ are less likely to engage in improvement efforts.

burnout

Walt Bogdnaich accused Radiation Oncology as a whole as lacking _________________________

commitment to safety

Modern radiation therapy is complex and rapidly evolving. The safe delivery of radiation therapy requires the ________________ and ___________________efforts of many individuals with varied responsibility

concentrated and coordinated

What type of bias is the highlighted words a part of? Say a woman is being treated for metastatic breast cancer (spread all the way to her bones) and she is being treated for that and has a new onset of symptoms: night sweats, fever and weight loss (B symptoms) and dr. orders imaging = lots of lymph node involvement. Dr. changes the meds shes on to give her something to treat the cancer more aggressively. Then finds out that she has a different type of primary cancer.

confirmation bias, the dr. knew that she had cancer and explained her symptoms by using the cancer she already had instead of seeking for a differnt cancer

what does "status quo" mean?

content where things are at the moment and are not looking for changes to anything

Walt Bogdanich wrote numerous article highlighting the _______________ occurring in Radiation Therapy

dangers of errors

Standard of Practice means...

define the practice and establish general and specific criteria to determine compliance

what is another name for participative leadership?

democratic leadership

communication of error disclosure should be ___________________, _______________________, &________________________.

empathetic, apologetic, and respectful

Reduced trust in Blame Culture involves....

employee, managment, and the patient and their families

Culture of safety enables improvements by managing human error and using ___________________ for the better of the collective group. (This is a significant point)

errors as learning experiences

Leadership's job is to _________________ Culture shift.

facilitate (must start from top down)

T/F: Psychology of Error and Psychology of Safety are pretty much the same thing.

false

T/F: errors in treatment, even minor ones, can not cause therapeutic failure.

false; it can cause therapeutic failure

Safety gaps lead to a ____________________________ environment

fearful

disclosure often relieves ______________ felt by healthcare workers.

guilt

In 2012 AHRQ survey showed that 50% of respondents felt mistakes were ________________________

held against them

The history of blame culture runs deep and in 2012 AHRQ survey showed that 65% of respondents worried that their mistakes were ________________________ .

held against them

high risk setting means

high potential for significant disaster or danger

a large number of similar events ________________ an issue in a process.

highlight

what is the cycle of blame culture? What does it all entail or lead to?

human error --> individual diciplined --> reduced trust --> less communication --> managment becomes disconnected --> latent problems exist --> more flawed defenses and error precursors --> back to human error

_______________________can be inhibited by lack of psychological safety.

improvement

A disruptive individual is someone who....

in the workplace exhibits: -derogatory -hypocrytical -aggressive -angry response

When items in plain sight reamain invisible to the viewer because they are not looking for those items or expecting to find them.

inattentional blindness

Errors can impact those of a clinical team__________________ or _______________ involved.

indirectly or directly

This improvement behavior is formal reporting to initiate improvment effort.

initiating

Which process of the psychology of error is considered "peripheral thinking" or "fast thinking"?

intuitive process

a majority of our day to day processes is what kind of process?

intuitive process

Incident Reporting Systems are used to trigger _________________.

investigations

When an ind. continues with a poor dicision becasue of the perceive dmound of work already put into that decision is ______________________________________. (also known as Sunk Cost Fallacy)

irrational escalation

What is a Safety Gap?

is that dimly lit space between what is and what should be, between the expectations set forth by your safety program and the actual work practices that take place on your work sites

Ambiguity effect is the tendency of decisions to be affected by ______________________________________.

lack of information

The 3rd principle of incident investigation is to choose ________________ appropriately to avoid any percetpion of blame.

language

Disclosure of errors results in fewer _____________________________&___________________________________.

law suites and medical malpractice claims.

Paradigm shifts take a lot of effort, especially from _______________.

leadership

The key to making improvements is to _____________________________.

learn from the errors reported

The _____________the time between incident and discussion of that problem, the less effective the conversation will be.

longer

Safety gaps lead to high number of ____________________.

medical errors

Safety _____________________in people must be nurtured over time.

mindfulness

Safety culture is a supportive environment with ___________________________________ which leads to safer practices.

open communication

The tendency to judge a decision or action by its eventual outcome, rather tahn the quality of the decision at the time it was made is considered to be what type of bias?

outcome bias

According to WHO, ___________________ to radiation occurs in cases of wrong-patient and wrong-site identification.

overexposure

Which leadership type is opposite of autocratic?

participative leadership

something must be done with the error reported otherwise...

people will stop reporting

Psychological safety enables a willingness to engage in ___________________.

problem solving

Which of the 5 categories of improvement behavior have defects that exist?

quick fixing and initiating

reporting cultures are linked to high-___________________ organizations.

reliablility

High Reliability Organizations (HROs) are defined by _________________.

results

Resilient near misses result in an increase of ____________________.

risk taking behaviors and don't want this in an organization

Vulnerable Near Miss: When a person thinks they just got lucky from error, it makes them more _______________ and makes them second guess the risky behavior.

safe

In radiation oncology a lot of new tech. (ex. IMRT) advances happen, having a focus of _____________ is important.

safety

Psychological safety and autonomy are linked to higher ___________________________ with productivity

satisfaction

Impact varies on a clinical team depending on the _____________________ of the error

severity

safety gaps prevents open admittance of errors and _____________________________

shared learning (open learning)

Culture of Safety is a ________________ and ________________ process.

slow and deliberate

Who would not work well in a Laissez-faire Leadership environment?

someone who gets distracted easily

Must use a ___________________________ to examine relationships between layers of a system.

systems approach

Where to HROs fall on the ladder of cultural safety?

the top/high end (Generative) -high information sharing -high trust and accountablility

Transactional or Transformational....which does Autocratic leadership fall under?

transactional

Transactional or Transformational....which does Bureaucratic leadership fall under?

transactional

Which type of leadership focuses on the exchange of interactions between leader and follower?

transactional

Which type of leadership gets things done quicker?

transactional

Which type of leadership gives punishment of negative feedback for noncompliance (corrective methods for unwanted behaviors)?

transactional

Which type of leadership has the focus of "WHAT"?

transactional

Which type of leadership is task-orientated (seeing what they can do and how)?

transactional

Which type of leadership rewards or gives positive feedback for compliance?

transactional

Transactional or Transformational....which does Laissez-faire leadership fall under?

transformational

Transactional or Transformational....which does Participative leadership fall under?

transformational

Which type of leadership creates an opening for new ideas?

transformational

Which type of leadership explains the rationale for tasks that need to be done? (This is what I want you to do and this is why I want you do do it.)

transformational

Which type of leadership focuses on the relationship between the leader and the follower?

transformational

Which type of leadership has a leader that creates a vison that followers buy into?

transformational

Which type of leadership has the focus of "WHY"?

transformational

Which type of leadership motivates individuals to do more than expected?

transformational

For patient Scott Jerome-Parks, what was forgotten during his treatment?

treatments were delivered without MLC in place and he couldn't eat as well as went blind and deaf

For Alexandra Jn-Charles what was forgotten during treatments?

treatments were delivered without a wedge in place and left her with a gaping hole

T/F: A blame-free culture is different than a blam-free policy.

true

T/F: Ultimately we, as RTs, are the ones telling the machine to turn on or off. So we are the cause to any consequeces that happen.

true

T/F: Radiation Therapists are at a high risk of developing burnout.

true; they have an increased risk of burnout compared to other healthcare professionals

Errors can develop decreased ____________________ among team members or of yourself.

trust

What type of reporting is it when everyone reports errors and people try to learn from them?

uninhibited reporting

Most impacts/effects on patients are most commonly ______________________

unknown; (due to underdosing and overdosing)

When an error does occur, the psychological impact is usually _____________________, why is this?

usually profound because the patient loses all confidence in the team and often times the whole org.