Patient Safety & Quality Improvement USMLE Step 1 Practice Question
A 78-year-old man with hypertension and depression presents to the emergency department with acute dizziness and near-syncope. Vital signs are BP 145/88 mmHg, HR 92 bpm, RR 16/min. Recent medication changes include initiation of lisinopril 10 mg daily 5 days ago and sertraline 50 mg daily 2 weeks ago. Physical examination reveals no orthostatic vital sign changes, and hemoglobin is 13.2 g/dL. Hospital data indicate that 80% of fall-related adverse events among patients over 75 years old occur within 2 weeks of new medication initiation. The hospital's quality improvement team implements a protocol requiring automatic pharmacist medication review and enhanced fall-prevention monitoring for all patients over 75 with recent medication changes. Which of the following quality improvement principles does this intervention best exemplify?
Answer choices
- ARisk stratification with targeted intervention based on patient-specific vulnerability factorsCorrect answer
- BStandardization of medication regimens across all elderly patients to reduce drug-drug interactions
- CUniversal application of equal monitoring intensity regardless of individual risk profile
- DRoot cause analysis of sentinel adverse events after fall-related injuries occur
- ERegulatory compliance documentation to satisfy hospital accreditation requirements
- FElimination of all polypharmacy in elderly patients through deprescribing protocols
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