Safety and quality improvement are essential components of pharmacy practice and healthcare systems. Pharmacists play a key role in identifying errors, implementing preventive strategies, and promoting a culture of safety. Understanding tools like root cause analysis (RCA), failure mode and effects analysis (FMEA), and performance metrics helps Pharm.D. students contribute to better patient outcomes. This 50-question MCQ quiz explores the systems, tools, and best practices used to reduce errors and enhance healthcare quality in pharmacy settings.
1. What is the primary goal of quality improvement in healthcare?
- A. Reducing staffing levels
- B. Enhancing patient outcomes and safety
- C. Increasing medication prices
- D. Promoting brand-name drugs
Correct answer: B. Enhancing patient outcomes and safety
2. A “near miss” is defined as:
- A. An error that caused patient harm
- B. A potential error that was caught before reaching the patient
- C. An intentional medication delay
- D. A late delivery
Correct answer: B. A potential error that was caught before reaching the patient
3. Root cause analysis (RCA) is used to:
- A. Punish individuals after an error
- B. Discover why a medication was out of stock
- C. Identify underlying causes of errors and prevent recurrence
- D. Evaluate staff productivity
Correct answer: C. Identify underlying causes of errors and prevent recurrence
4. What is the first step in conducting a root cause analysis?
- A. Notify HR
- B. Identify what happened and collect data
- C. Interview patients
- D. File an insurance claim
Correct answer: B. Identify what happened and collect data
5. The “Swiss cheese model” in patient safety represents:
- A. Food interactions with medications
- B. Layers of defense that, when aligned in error, allow harm to occur
- C. Cheese-based diet errors
- D. Packaging systems
Correct answer: B. Layers of defense that, when aligned in error, allow harm to occur
6. Which of the following is a proactive risk assessment tool?
- A. RCA
- B. SWOT
- C. FMEA (Failure Mode and Effects Analysis)
- D. SWOT
Correct answer: C. FMEA (Failure Mode and Effects Analysis)
7. High-alert medications require special handling because:
- A. They are expensive
- B. Errors with them have a higher risk of causing serious harm
- C. They are difficult to store
- D. They are not FDA-approved
Correct answer: B. Errors with them have a higher risk of causing serious harm
8. One of the key strategies to prevent medication errors is:
- A. Ignoring alerts
- B. Using tall man lettering for look-alike drug names
- C. Dispensing more than prescribed
- D. Using only brand names
Correct answer: B. Using tall man lettering for look-alike drug names
9. A “just culture” in safety improvement refers to:
- A. Punishing individuals for all errors
- B. Blaming the system for everything
- C. Encouraging open reporting while distinguishing between human error and negligence
- D. Avoiding documentation
Correct answer: C. Encouraging open reporting while distinguishing between human error and negligence
10. What does “continuous quality improvement” (CQI) emphasize?
- A. Occasional reviews
- B. Ongoing, data-driven improvements in processes and outcomes
- C. Top-down decisions only
- D. Budget cuts
Correct answer: B. Ongoing, data-driven improvements in processes and outcomes
11. Bar code medication administration (BCMA) helps reduce errors by:
- A. Speeding up workflow
- B. Verifying patient and medication match at the point of care
- C. Automatically printing prescriptions
- D. Replacing pharmacists
Correct answer: B. Verifying patient and medication match at the point of care
12. A medication error that reaches the patient but does not cause harm is classified as:
- A. Sentinel event
- B. No-harm event
- C. Root error
- D. System failure
Correct answer: B. No-harm event
13. Which of the following is considered a sentinel event?
- A. Minor headache from a medication
- B. An error causing death or serious injury
- C. Delayed insurance coverage
- D. Near miss
Correct answer: B. An error causing death or serious injury
14. The “Plan-Do-Study-Act” (PDSA) cycle is used in:
- A. Budget planning
- B. Quality improvement efforts
- C. Technician training
- D. Marketing campaigns
Correct answer: B. Quality improvement efforts
15. One purpose of reporting medication errors is to:
- A. Assign blame
- B. Reduce trust
- C. Learn from events and prevent recurrence
- D. Alert patients
Correct answer: C. Learn from events and prevent recurrence
16. Which organization maintains the National Medication Error Reporting Program (MERP)?
- A. CDC
- B. ISMP (Institute for Safe Medication Practices)
- C. FDA
- D. DEA
Correct answer: B. ISMP (Institute for Safe Medication Practices)
17. What is a common root cause of medication errors?
- A. Patient behavior
- B. Illegible handwriting
- C. System or process failures
- D. Brand preference
Correct answer: C. System or process failures
18. The goal of a safety culture is to:
- A. Ignore small errors
- B. Promote secrecy
- C. Encourage transparency and learning from mistakes
- D. Protect management only
Correct answer: C. Encourage transparency and learning from mistakes
19. What tool is used to predict potential failures in a process?
- A. CQI
- B. SWOT
- C. FMEA
- D. KPI
Correct answer: C. FMEA
20. In quality improvement, a KPI stands for:
- A. Key Patient Issue
- B. Known Prescription Intake
- C. Key Performance Indicator
- D. Kind Provider Initiative
Correct answer: C. Key Performance Indicator
21. Which system promotes medication error prevention through alerts and checks?
- A. Barcode inventory
- B. EHR with clinical decision support
- C. Pharmacy label printer
- D. Manual order forms
Correct answer: B. EHR with clinical decision support
22. A sentinel event must be:
- A. Hidden
- B. Ignored
- C. Investigated and reported immediately
- D. Accepted as normal
Correct answer: C. Investigated and reported immediately
23. Which healthcare model focuses on reducing harm through system improvement?
- A. Fee-for-service
- B. Quality assurance
- C. High-reliability organization (HRO)
- D. Marketing-based care
Correct answer: C. High-reliability organization (HRO)
24. What is an example of a system-level safety intervention?
- A. Dismissing staff
- B. Barcode scanning implementation
- C. Advertising campaigns
- D. Manual transcription
Correct answer: B. Barcode scanning implementation
25. Medication reconciliation is essential for:
- A. Billing
- B. Checking insurance
- C. Preventing medication discrepancies across care transitions
- D. Verifying prescriber credentials
Correct answer: C. Preventing medication discrepancies across care transitions
26. What role do pharmacists play in quality improvement?
- A. Only dispensing
- B. Monitoring, reporting, and developing safer processes
- C. Limiting access
- D. Managing parking spaces
Correct answer: B. Monitoring, reporting, and developing safer processes
27. When should quality improvement be initiated?
- A. After major errors only
- B. Once a year
- C. Continuously, as part of normal workflow
- D. Only when required by law
Correct answer: C. Continuously, as part of normal workflow
28. How can pharmacies track error trends?
- A. Delete records
- B. Keep verbal notes
- C. Use structured reporting systems and analyze data
- D. Avoid feedback
Correct answer: C. Use structured reporting systems and analyze data
29. Which concept supports learning from small process failures before harm occurs?
- A. Peer review
- B. Just culture
- C. Hindsight bias
- D. Safety huddles
Correct answer: D. Safety huddles
30. What is the role of a medication safety officer?
- A. Writing prescriptions
- B. Preventing physical hazards
- C. Overseeing safety practices and analyzing risk events
- D. Managing legal forms
Correct answer: C. Overseeing safety practices and analyzing risk events
31. Reducing variation in healthcare processes contributes to:
- A. Slower service
- B. Increased advertising
- C. Improved safety and quality
- D. Higher costs
Correct answer: C. Improved safety and quality
32. What is a “never event”?
- A. A delayed refill
- B. A minor side effect
- C. A preventable serious error that should never occur
- D. A rare lab test
Correct answer: C. A preventable serious error that should never occur
33. Which agency promotes national patient safety goals?
- A. DEA
- B. TJC (The Joint Commission)
- C. CMS
- D. USDA
Correct answer: B. TJC (The Joint Commission)
34. A “SMART” quality goal is:
- A. Simple, Magical, Active, Reactive, Timed
- B. Specific, Measurable, Achievable, Relevant, Time-bound
- C. Secure, Marketed, Alert, Regional, Technological
- D. Shared, Managed, Aligned, Reported, Tagged
Correct answer: B. Specific, Measurable, Achievable, Relevant, Time-bound
35. Which of the following supports a culture of safety?
- A. Hiding errors
- B. Encouraging error reporting without punishment
- C. Enforcing silence
- D. Avoiding patient involvement
Correct answer: B. Encouraging error reporting without punishment
36. Which metric reflects pharmacy service quality?
- A. Number of staff
- B. Prescription error rate
- C. Cost of medication
- D. Room temperature
Correct answer: B. Prescription error rate
37. Which of the following helps reduce transcription errors?
- A. Verbal orders
- B. Electronic prescribing
- C. Handwritten notes
- D. Post-it reminders
Correct answer: B. Electronic prescribing
38. Quality improvement projects should involve:
- A. Management only
- B. External consultants
- C. Frontline staff who know the workflow
- D. Legal teams
Correct answer: C. Frontline staff who know the workflow
39. Using visual alerts for high-risk medications is a:
- A. Safety distraction
- B. Human error
- C. Preventive strategy
- D. Legal requirement
Correct answer: C. Preventive strategy
40. After an error, the most important pharmacy response is to:
- A. Ignore it
- B. Punish the individual
- C. Report it, investigate, and improve the system
- D. Blame the computer
Correct answer: C. Report it, investigate, and improve the system
41. Benchmarking in quality improvement refers to:
- A. Measuring marketing results
- B. Comparing processes or outcomes with best practices or peers
- C. Estimating budgets
- D. Documenting prescriptions
Correct answer: B. Comparing processes or outcomes with best practices or peers
42. Which activity reduces variability in medication preparation?
- A. Verbal handoffs
- B. Standardized protocols and checklists
- C. Manual labeling
- D. Rushed workflow
Correct answer: B. Standardized protocols and checklists
43. Pharmacy quality indicators may include:
- A. Patient foot traffic
- B. Drug costs
- C. Counseling rate for new prescriptions
- D. Room décor
Correct answer: C. Counseling rate for new prescriptions
44. Which tool summarizes process flow to identify weak points?
- A. Root cause map
- B. Flowchart
- C. Policy binder
- D. Calendar
Correct answer: B. Flowchart
45. High-risk transitions of care are associated with:
- A. Minimal change
- B. Increased errors
- C. Faster billing
- D. Better pricing
Correct answer: B. Increased errors
46. Which technology supports safe medication storage?
- A. Crates
- B. Open shelving
- C. Automated dispensing cabinets
- D. Paper bins
Correct answer: C. Automated dispensing cabinets
47. Which approach helps sustain improvement initiatives?
- A. One-time training
- B. Regular audits and staff engagement
- C. Anonymous suggestion boxes only
- D. Management-only meetings
Correct answer: B. Regular audits and staff engagement
48. Safety events should be viewed as:
- A. Legal violations
- B. Learning opportunities
- C. Unimportant
- D. Solely financial issues
Correct answer: B. Learning opportunities
49. Which principle supports better reporting systems?
- A. Confidentiality and non-punitive feedback
- B. Public shaming
- C. Delayed response
- D. No follow-up
Correct answer: A. Confidentiality and non-punitive feedback
50. Ultimately, the goal of safety and quality improvement is to:
- A. Maximize billing
- B. Avoid new technologies
- C. Deliver safer, more effective care to patients
- D. Simplify staffing
Correct answer: C. Deliver safer, more effective care to patients