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Handoff standardization — USMLE Step 3 MCQ

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HardEthics, Patient Safety, Quality Improvement, Systems-Based PracticeHandoff standardizationUSMLE Step 3

A patient receives a tenfold insulin overdose after a concentration change, develops severe hypoglycemia, and requires intensive care. Leadership wants to identify latent workflow, labeling, and electronic-order contributors before redesigning the process. Which quality method is most appropriate first?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Review the event using root-cause analysis and a systems action plan

The best answer is “Review the event using root-cause analysis and a systems action plan”. Root-cause analysis is the appropriate retrospective systems method after a serious adverse event. Failure-mode-and-effects analysis is valuable prospectively when evaluating how a proposed process might fail, but it does not replace investigation of the event that already occurred.

Reference: AHRQ Patient Safety Primer: Root Cause Analysis: https://psnet.ahrq.gov/primer/root-cause-analysis