Root cause analysis (RCA) is a structured process to identify underlying causes of significant safety events to prevent recurrence. It is typically reserved for serious incidents with high potential for harm.
Option A (Patient death): Not all patient deaths require RCA unless they meet sentinel event criteria (e.g., unexpected death due to error).
Option B (Medication error): Medication errors may warrant RCA if severe, but not all errors meet this threshold.
Option C (Sentinel event): This is the correct answer. The NAHQ CPHQ study guide states, “A root cause analysis is required for sentinel events, defined as unexpected occurrences involving death or serious physical or psychological injury, or the risk thereof” (Domain 1). The Joint Commission mandates RCA for sentinel events like wrong-site surgery.
Option D (Near miss): Near misses are analyzed to improve systems but typically do not require formal RCA unless they indicate significant risk.
CPHQ Objective Reference: Domain 1: Patient Safety, Objective 1.5, “Conduct root cause analysis for significant safety events,” specifies RCA for sentinel events. The NAHQ study guide notes, “RCA is a critical tool for analyzing sentinel events to prevent future harm” (Domain 1).
Rationale: Sentinel events, due to their severity, mandate RCA to identify and address root causes, aligning with CPHQ’s patient safety principles.
[Reference: NAHQ CPHQ Study Guide, Domain 1: Patient Safety, Objective 1.5., , , ]