PHCM9748 Clinical Governance and Risk Management

1.Describe the process you would use for selection of your Root Cause Analysis team.  Outline who you would include; who you would exclude; and your rationale for these decisions .

2.Describe one or more incident investigation techniques that you would utilise to investigate this event. Summarise the key strengths and limitations of this technique.

3.Provide a concise narrative chronological account of what happened to this patient

4.Insert a process diagram demonstrating what happened to this patient

5.Populate the Root Causes and Contributing Factors

6.Populate RCA team recommendations