Root Cause Analysis Quality and Patient Safety Council

1. Root Cause AnalysisQuality and Patient Safety Council August 12, 2009 Privileged and Confidential Under the Ohio Revised Code. The documents contained within are confidential professional/ peer review and quality assessment documents of the UTMC. It is protected from disclosure pursuant to the provisions of ORC 2305.25, ORC 2305.251, and ORC 305.253. Unauthorized disclosure or duplication is absolutely prohibited.

2. Sentinel Event/Adverse Event/RCA

3. Case Summary

4. Root Cause (s)

5. Contributing Factors

6. Contributing Factors

7. Other Investigatory Findings

8. Risk Reduction Strategies

9. Further Discussion–Final Approval