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Root cause analysis — USMLE Step 3 MCQ

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HardEthics, Patient Safety, Quality Improvement, Systems-Based PracticeRoot cause analysisUSMLE Step 3

A hospital has three wrong-site near misses, each caught before incision. Leadership wants a systems response. Which intervention is best?

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Correct answer: A — Require site marking, verification, and a team time-out before incision

The Universal Protocol uses verification, site marking, and a final time-out immediately before the procedure. Memory, delayed checks, and suppression of near-miss reports do not create a reliable control.

Reference: The Joint Commission, Universal Protocol: https://www.jointcommission.org/standards/universal-protocol/