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May/June 2014

Quality Conundrums

Accountability vs. Just Culture – A Quality Conundrum?

Does a culture of accountability demand that physicians and nurses who make mistakes be punished under all circumstances? Does a punitive environment increase or decrease the likelihood of errors? Conversely, does a “Just Culture,” with its emphasis on the system rather than individual errors, mean that individual castigation is never appropriate? Health care providers, most notably physicians and nurses, have long focused on individual responsibility for professional performance as a core value. How easily does that culture adapt to new ideas without eviscerating its core?

In Patient Safety and the “Just Culture”: A Primer For Health Care Executives, David Marx elegantly describes an approach to dealing with the tension between punishment (accountability) and communication (Just Culture).1

In a section outlining Disciplinary System Theory, Mr. Marx details four behavioral constructs that he labels the four evils of disciplinary systems: human error, negligence, reckless conduct, and intentional rule violations. He also reviews three Disciplinary Decision-Making Strategies: Outcome-Based Disciplinary Decision-Making, Rule-Based Disciplinary Decision-Making, and Risk-Based Disciplinary Decision-Making. This framework remains easily accessible and applicable across a wide range of situations.

Progress towards a safer environment for patients is slower than most of us would like. While health care’s cultural challenges remain high barriers to transparency and patient safety, so are legal and interpersonal barriers. Mr. Marx’s summary cogently describes these challenges and suggests solutions.

Meanwhile, whether clinicians involved in medical mishaps can safely and appropriately continue to practice in the same environment, or even want to, is unlikely. Perhaps we should reevaluate how we treat our colleagues who are involved in a patient safety event.  Until we do, both patients and clinicians may suffer unnecessarily in the aftermath of an avoidable harm event.

1  Accessed May 7, 2014.

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ABQAURP welcomes applications for joint sponsorship of educational activities for continuing education credit. ABQAURP accredits a variety of activities, including:

Live Activity
Enduring Material
Journal-based CME
Internet Activity Live
Internet Activity Enduring Material
Performance Improvement

ABQAURP is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians and is accredited by the Florida Board of Nursing to sponsor nursing contact hours. As an accredited provider, ABQAURP is here to work with each joint sponsor organization to ensure the accreditation process runs as smoothly as possible. Benefits of working with ABQAURP include: one-on-one assistance, on-site assistance, contact for speakers and commercial supporters, evaluation compilation, one-time mailing list to drive attendance, website placement, and advertising in Patient Safety & Quality Healthcare magazine.

For more information, please call Deborah Naser at
(800) 998-6030, ext. 118.

ABQAURP Welcomes New Joint Sponsor Organization: AIEME

We would like to welcome the The Associates In Emergency Medical Education, Inc., better known by their trademarked name of AIEME™. AIEME is based out of Tampa Bay, Florida but serves hospitals and agencies throughout the United States, Europe, Costa Rica, and the Caribbean.

Watch for their upcoming accredited program: Reducing Military Drug Abuse & Suicide: Leaving One War to Face

Continuing Education Requirements Changing in Florida

A new license renewal process will verify a practitioner’s continuing education record in the electronic tracking system at the time of license renewal. The program is part of the Florida Division of Medical Quality Assurance’s commitment to expeditiously license health care professionals who meet statutorily mandated standards of competency. The Department encourages licensees to login to the tracking system before applying for renewal to ensure their information is complete and accurate. Verifying compliance before renewal is key to a seamless renewal experience. To learn more about CE/CME@Renewal, please visit

ABQAURP automatically reports credits earned.
Please provide your current Florida License number
to ABQAURP to ensure proper reporting
to CE Broker when completing a course.

 Core Body of Knowledge Online Course –
20 CME/CE Hours!

The journey towards certification begins here. ABQAURP’s HCQM Certification covers an immense scope of content and topics. To aid you in preparation for this exam, we have developed a Core Body of Knowledge course designed to focus on key concepts and elements of HCQM. By utilizing this tool, you will build upon your existing skills and knowledge and possibly discover new content that will enhance your experience in quality health care.

Please call Barbara Morris at (800) 998-6030, extension 116, or visit our website ( for more information on Certification and preparation.

Health Care Quality and Management (HCQM) Certification

When deciding on a credential, you want the most comprehensive certification covering the health care quality continuum. Choose the provider with the experience that defines the field of Health Care Quality and Management.

ABQAURP is pleased to collaborate with the National Board of Medical Examiners® (NBME®) in the administration of the 2014 exam. ABQAURP is dedicated to assuring a high quality certification process with definable standards; the NBME involvement reinforces that dedication. Together, we consult on the planning, development, analysis, and scoring, bringing examinees an exam experience based on a vast array of knowledge and expertise.

We are now accepting applications for
HCQM Certification in 2014!

Application Deadline: June 30
Exam Window: August 15 – October 15

Don’t delay, seating is limited!

Upcoming ABQAURP Accredited Events


The Source: “What’s New” Monthly Articles
Ongoing – Online Education

Practical Approach to Problem Wounds
Wound Care Review Course
Total Contact Casting: The Gold Standard of Care
Total Contact Casting: Efficacy and Application
Ongoing – Online Education

NeuroResearch Clinics
Advances in Clinical Laboratory Medicine
June 7, 2014
Santa Monica, CA

World Congress Events

Health Care Quality Improvement & Cost Containment Summit
June 24, 2014
Philadelphia, PA

Patient Flow & Emergency Management
Summit and Pre-Conference Workshop
June 25, 2014
Chicago, IL


ABQAURP’s 38th Annual HCQ & PS Conference
April 17, 2015
Royal Sonesta Hotel Houston
Houston, TX

To accredit your educational events for continuing education credit, contact Deborah Naser at 800-998-6030, ext. 118.

A special thank you to the attendees, faculty, and exhibitors
for a successful Annual Conference!

A sincere thank you to all who attended ABQAURP’s 37th Annual Health Care Quality & Patient Safety Conference, Getting Paid for Innovation and High Value Outcomes: The Path to Cost Effective, Accessible Health Care for All, on Friday, May 2, 2014, at Disney’s Yacht & Beach Club Resorts in Lake Buena Vista, Florida.

If you missed the conference, watch for the self-study versions being released soon!

ABQAURP wants to recognize members for their achievements in advancing the field of health care quality management and patient safety. Please send your news to ABQAURP by email to This email address is being protected from spambots. You need JavaScript enabled to view it. for consideration.


American Board of Quality Assurance and Utilization Review Physicians, Inc.
6640 Congress Street
New Port Richey, FL 34653
Toll- free 800/998-6030 • Tel. 727/569-0190
Fax 727/569-0195 •

“National Board of Medical Examiners®” and “NBME®” are registered trademarks of the National Board of Medical Examiners.



ABQAURP American Society for Quality American Society for Quality Healthcare Division Consumers Advancing Patient Safety
EMPSF Institute for Safe Medical Practices
Medically Induced Trauma Support Services (MITSS) Medication Safety Officers Society NPSF Partnership for Patient Safety Society to Improve Diagnosis in Medicine