Application of Human Factors Methods to Ensure Appropriate Infant Identification and Abduction Prevention Within the Hospital Setting.

Infant misidentification and abduction are recognized as "never" events for hospitals in the United States. As near misses are often unreported, root cause analysis of observed near misses may fail to uncover important contributors. We utilized failure mode and effects analysis to proactively identify and eliminate or reduce the risk of infant misidentification or abduction. We prioritized action plans based upon the highest risk priority failures and developed steps to eliminate the gaps in the infant identification process and the security within the Center for Women & Infants. The analysis identified 28 failure modes. Team discussion of the failure modes also yielded several collateral benefits of improvements in the unit climate. We present and discuss the action plans that were undertaken by the hospital to increase patient safety and reduce the risk of infant misidentification and abduction.

Factors Associated with Quality and Adequacy of Medical Student Feedback on Core Obstetrics and Gynecology Clerkships from the Student and Clerkship Director Perspective: Secondary Analyses of a Prospective Cohort Study.

OBJECTIVE: We sought to investigate factors associated with improved feedback quality during third-year obstetrics and gynecology (OBGYN) clerkships. DESIGN: This prospective cohort study assessed relationships of student and clerkship characteristics to the quantity and quality of feedback during OBGYN clerkships according to the clerkship director and third-year medical students. SETTING: This study took place in a university-based hospital setting in which medical students rotate for 6 weeks on core clerkships during the third year of medical school. PARTICIPANTS: Third year medical students participating in core OBGYN clerkships during the 2018 to 2019 academic year. RESULTS: One hundred and ten students participated. Students with better clerkship scores reported higher quality of feedback, effectiveness of teaching, and quality of the clerkship overall, but did not receive a higher quantity or quality of feedback per the clerkship director. In multivariate modeling, the only factor affecting the clerkship director's rating of feedback adequacy was the number of preceptors who had given feedback. Factors associated with better student-reported feedback quality included midclerkship feedback adequacy and attendings and residents teaching procedures. CONCLUSIONS: Improved feedback for medical students on core OBGYN clerkships is associated with more preceptors offering feedback, midclerkship feedback adequacy, and preceptors teaching procedures.