Identify the members of the interdisciplinary team who will be included in the RCA and FMEA.
Articulation of Response (clarity, organization, mechanics) The candidate provides unsatisfactory articulation of response. The candidate provides weak articulation of response. The candidate provides limited articulation of response. The candidate provides adequate articulation of response. The candidate provides substantial articulation of response.
A. Root Cause Analysis The candidate does not complete an appropriate root cause analysis that takes into consideration causative factors that led to the sentinel event. The candidate completes an appropriate root cause analysis, with no detail, that takes into consideration causative factors that led to the sentinel event. The candidate completes an appropriate root cause analysis, with limited detail, that takes into consideration causative factors that led to the sentinel event. The candidate completes an appropriate root cause analysis, with adequate detail, that takes into consideration causative factors that led to the sentinel event. The candidate completes an appropriate root cause analysis, with substantial detail, that takes into consideration causative factors that led to the sentinel event.
A1. Errors or Hazards The candidate does not provide a logical discussion of the errors or hazards in care in the scenario. The candidate provides a logical discussion, with no detail, of the errors or hazards in care in the scenario. The candidate provides a logical discussion, with limited detail, of the errors or hazards in care in the scenario. The candidate provides a logical discussion, with adequate detail, of the errors or hazards in care in the scenario. The candidate provides a logical discussion, with substantial detail, of the errors or hazards in care in the scenario.
B. Improvement Plan The candidate does not use change theory to develop an appropriate improvement plan to decrease the likelihood of a reoccurrence of the outcome of the scenario. The candidate uses change theory to develop an appropriate improvement plan, with no detail, to decrease the likelihood of a reoccurrence of the outcome of the scenario. The candidate uses change theory to develop an appropriate improvement plan, with limited detail, to decrease the likelihood of a reoccurrence of the outcome of the scenario. The candidate uses change theory to develop an appropriate improvement plan, with adequate detail, to decrease the likelihood of a reoccurrence of the outcome of the scenario. The candidate uses change theory to develop an appropriate improvement plan, with substantial detail, to decrease the likelihood of a reoccurrence of the outcome of the scenario.
C. FMEA The candidate does not use a failure mode and effects analysis to project the likelihood that the process improvement plan suggested would not fail. The candidate uses a failure mode and effects analysis, with no support, to project the likelihood that the process improvement plan suggested would not fail. The candidate uses a failure mode and effects analysis, with limited support, to project the likelihood that the process improvement plan suggested would not fail. The candidate uses a failure mode and effects analysis, with adequate support, to project the likelihood that the process improvement plan suggested would not fail. The candidate uses a failure mode and effects analysis, with substantial support, to project the likelihood that the process improvement plan suggested would not fail.
C1.
Interventions The candidate does not provide a logical explanation of how to test any interventions to improve care in a similar situation by changing the process of care. The candidate provides a logical explanation, with no support, of how to test any interventions to improve care in a similar situation by changing the process of care. The candidate provides a logical explanation, with limited support, of how to test any interventions to improve care in a similar situation by changing the process of care. The candidate provides a logical explanation, with adequate support, of how to test any interventions to improve care in a similar situation by changing the process of care. The candidate provides a logical explanation, with substantial support, of how to test any interventions to improve care in a similar situation by changing the process of care.
C2. Pre-Steps The candidate does not provide a logical discussion of pre-steps for preparing for the FMEA. The candidate provides a logical discussion, with no detail, of pre-steps for preparing for the FMEA. The candidate provides a logical discussion, with limited detail, of pre-steps for preparing for the FMEA. The candidate provides a logical discussion, with adequate detail, of pre-steps for preparing for the FMEA. The candidate provides a logical discussion, with substantial detail, of pre-steps for preparing for the FMEA.
C3. Three Steps The candidate does not provide an appropriate description of the 3 steps of the FMEA: severity, occurrence, and detection. The candidate provides an appropriate description, with no detail, of the 3 steps of the FMEA: severity, occurrence, and detection. The candidate provides an appropriate description, with limited detail, of the 3 steps of the FMEA: severity, occurrence, and detection. The candidate provides an appropriate description, with adequate detail, of the 3 steps of the FMEA: severity, occurrence, and detection. The candidate provides an appropriate description, with substantial detail, of the 3 steps of the FMEA: severity, occurrence, and detection.
