Patient Safety & Quality Improvement USMLE Step 1 Practice Question
A 67-year-old man with atrial fibrillation is anticoagulated with warfarin. He visits three different clinics for medication refills and has labs drawn at each site, but results are not integrated in a unified EHR system. One clinic increases his warfarin dose without knowledge of a recent INR of 4.2 obtained at another clinic. He develops a hemorrhagic stroke. Which quality and safety concept does this exemplify?
Answer choices
- AInadequate laboratory testing for INR monitoring in anticoagulation
- BPatient non-adherence from visiting multiple clinics without coordination
- CFragmentation of care due to lack of interoperable health information systemsCorrect answer
- DProvider knowledge deficit regarding warfarin dosing in elderly patients
- EMedication error from provider misreading of the prescription label
- FFailure of the patient to disclose his warfarin use across different healthcare providers
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