SAMSQUESTIONSET

For Presentation titled: “Safety Culture Leadership: What Can We Learn from High-Reliability Organizations?”

David W. Jordan, Ph.D., University Hospitals Case Medical Center, Cleveland, OH

For AAPM Spring Clinical Meeting, Denver, CO, March 2014

1.Which of the following is a safety culture trait defined by the U.S. Nuclear Regulatory Commission?

a)Commitment to resilience

b)Deference to expertise

c)Sensitivity to operations

d)Questioning attitude

e)Preoccupation with failure

Answer: d–Questioning attitude

Ref: “Safety Culture Policy Statement Brochure”,US Nuclear Regulatory Commission NUREG/BR-0500(2012).

2. Which of the following safety culture traits, if absent in an organization, would most likely result in front-line staff members failing to report near-miss safety events?

a)Continuous learning

b)Respectful work environment

c)Environment for raising concerns

d)Standardized work processes

e)Personal accountability

Answer: c–Environment for raising concerns

Ref: “Improving Patient and Worker Safety: Opportunities for Synergy, Collaboration, and Innovation”,Joint CommissionReport (2012)

3. Why must high reliability organizations develop resilience instead of simply preventing errors?

a)HRO operations are fast-paced and require quick decision-making.

b)HROs have very complex operations that lead to normal accidents.

c)HRO operations are hazardous so that errors can causegreat harm.

d)HROs have distributed operations so that error-based learning is difficult.

e)HRO operations are hierarchical and require rigid standard operating procedures.

Answer: b–HROs have very complex operations that lead to normal accidents.

Ref: “Managing the Unexpected”,Weick & Sutcliffe(2001), p. 69-73.

4. If a linear accelerator displays an error message and the medical physicist asks the radiation therapist and service engineer to make a “treat/don’t treat” recommendation, which HRO trait is exhibited in this department?

a)Preoccupation with failure

b)Reluctance to simplify interpretations

c)Sensitivity to operations

d)Commitment to resilience

e)Deference to expertise

Answer: e – Deference to expertise

Ref: “Managing the Unexpected”,Weick & Sutcliffe(2001), p. 16-17.

5. A nuclear medicine department investigates a technologist accidentally injecting PET tracer into a patient who was in the waiting room for an ultrasound exam. A hospital risk management official states that the technologist failed to follow the established ID-check procedure and recommends discipline for the technologist. If the department elects to probe the incident for other root causes, which HRO trait does it demonstrate?

a)Preoccupation with failure

b)Reluctance to simplify interpretations

c)Sensitivity to operations

d)Commitment to resilience

e)Deference to expertise

Answer: b – Reluctance to simplify interpretations

Ref: “Managing the Unexpected”,Weick & Sutcliffe(2001), p. 59-62.