Patient Safety & Quality Improvement USMLE Step 1 Practice Question
A 28-year-old primigravida at 32 weeks gestation presents for routine prenatal care. Vital signs: BP 158/95 mmHg, HR 92/min, RR 16/min, Temp 37.2°C. Laboratory results reveal proteinuria 2+ and platelet count 185,000/μL. The patient's electronic health record (EHR) system generates automated alerts flagging critical vital signs and laboratory abnormalities consistent with preeclampsia. However, review of the medical record reveals that the clinical team did not review or act upon these alerts before completing their assessment and discharge planning. The patient subsequently develops eclamptic seizures at home 48 hours later and is readmitted via emergency department. Root cause analysis of this near-miss event identifies that the EHR generates an average of 96 alerts per patient encounter, with only 5% clinically actionable. Which of the following best characterizes the primary systems-level factor that contributed to this adverse outcome?
Answer choices
- AAlert fatigue resulting in failure to process clinically relevant warnings among high volumes of non-actionable notificationsCorrect answer
- BInadequate physician competency in obstetric risk stratification and management of hypertensive disorders
- CFailure to implement standardized protocols for EHR system validation prior to clinical deployment
- DInsufficient staffing ratios in the obstetric unit limiting time available for comprehensive chart review
- ELack of institutional malpractice insurance coverage for complications of preeclampsia
- FAbsence of informed consent documentation regarding risks of gestational hypertension at the initial prenatal visit
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