A multicentered academic medical center experience of a simulated root cause analysis (RCA) for hematology/oncology fellows.

Abstract

188 Background: Quality improvement and patient safety education is an Accreditation Council for Graduate Medical Education (ACGME) common program requirement for hematology/oncology fellowships. Specifically, the ACGME requires trainee participation in interprofessional clinical patient safety activities, such as root cause analyses. These can be challenging to incorporate into busy schedules and are intimidating to some trainees, but simulated RCAs are a novel way to assure trainees gain important patient safety skills. We report on a multicentered experience utilizing a simulated RCA educational module in an attempt to provide fellows with the tools needed to participate in a live RCA and to increase awareness of the need to analyze patient safety events. Methods: The two-hour module included a didactic session explaining the basics of an RCA including common terminology, effective chart review, and personal interviews. The fellows assessed a patient safety event of a missed coagulopathy and created an event flow map and fishbone analysis. They then formed root cause/contributing factor statements and proposed a solution. Seventeen fellows from two institutions completed pre- and post-session surveys regarding the experience. Results: There was a 47% increase in both the percentage of fellows who felt comfortable participating in live RCAs in the future, and in the number of fellows who felt comfortable with using the tools typically utilized in an RCA. 70.59% of respondents felt that as a result of the mock RCA, they were more likely to report a near miss or adverse event. Conclusions: Mock RCAs are a feasible method of incorporating ACGME-required patient safety activities into hematology/oncology fellow education and are effective in increasing their comfort and understanding of important quality improvement skills

Application of Isothermal Signal Amplification Technique in the Etiological Diagnosis of Gonorrhea and Drug Resistance Gene Detection

“…And the differences in sensitivity and specificity between urine isothermal signal amplification technique method and swab isothermal signal amplification technique method were not statistically significant, suggesting that both isothermal signal amplification technique method can use urogenital tract secretions and urine as samples to be tested and urine as a noninvasive sampling to avoid the embarrassment and pain of swab sampling in male patients [29]. Therefore, in case of rejection or difficulty in urethral swab sampling in male patients, retention of urine specimens for examination can be considered according to the actual situation, but the concept of first voided urine must be clearly defined at the time of retention of urine specimens, i.e., the time of urine retention must be at least 2 h from the last voided urine, and it must be 30 mL of the first segment of urine [30]. This will ensure accurate and reliable test results.…”