NAHQ CPHQ Certification CPHQ Question # 143 Topic 15 Discussion

Sentinel events are serious patient safety incidents that signal a need for immediate investigation or response1. Reducing sentinel events in a care delivery system requires a comprehensive approach that includes various strategies2. One of the most effective strategies is layering methods of mistake-proofing2. This involves designing or redesigning systems to reduce and prevent errors2. It also includes enhancing education and training, teamwork, self-assessment, and information management2. These proactive efforts have been shown to reduce and prevent errors2.