Write a 5-7 page recommendation to senior leadership about steps the organization needs to take to resolve a patient safety issue that occurred. Include an explanation of why it is important to address the issue and the role the patient safety officer will play in helping to resolve the issue. Alarming numbers of unnecessary patient deaths occur in U.S. hospitals and around the world. "Quality and patient safety in health care have been on the forefront of the public's mind since the publication of the Institute of Medicine's (IOM) seminal report, 'To Err Is Human,' in 1999" (Johnson, Haskell, & Barach, 2016, pg. xv). The literature supports revising systems and processes in an effort to narrow the difficult safety and quality gaps. Worldwide, issues of patient safety and patient-centered quality care drive health care reform. Current approaches are not adequate; patients remain at risk for needless harm.

For the scenario you selected, write a five- to seven-page recommendation for leadership that describes the safety threat, the importance of addressing the threat, and your recommendations for resolving it. Be sure to include all of these headings in your paper and to address all of the bullets underneath each heading: Potential threat to patient safety: Identify the issue you selected from the simulation activity as the potential safety threat. Describe the issue that occurred with sufficient detail so that leadership has a clear understanding of what happened. Implications of not addressing threat: Evaluate the risk to the organization if this issue is not addressed. In your evaluation, be sure to address all of the following: What does the health care safety imperative say about the issue? How does the health care safety imperative apply in this case? Which regulatory agency(ies) have oversight about the issue? What specifically do the regulation(s) state about the issue? For example, you might consider the Joint Commission's national patient safety goals. What impact do regulatory agencies have on organizations' patient safety programs? How do health care organizations incorporate regulatory agencies' guidance when establishing reporting and investigation best practices? If the hospital fails to correct the threat, what are the potential consequences to patients, employees, and to the organization? Patient safety officer's role in effective implementation of patient safety plans: Explain the role patient safety officers assume in implementing patient safety plans in health care organizations. Clarify your responsibility and role as the patient safety officer in this specific instance. Provide one example from the literature to illustrate your points. Recommendations to reduce patient safety threat: Describe your five-point plan to reduce or eliminate this patient safety threat. What best practice tools or techniques does your plan include to reduce or eliminate these types of errors? Consider processes for responding, rounding, detecting, incident reporting, operational considerations, et cetera. In a health care professional setting, recommendations to leadership would typically not be in APA format. As a result, your paper does not need to conform to APA format and style guidelines. It does, however, need to be clear, persuasive, organized, and well written without spelling, grammar, and/or punctuation errors. In addition, recommendations you write in a professional setting would be single-spaced. For the purpose of this assessment, however, please use double-spacing. Also, health care is an evidence-based field. Your senior leaders will want to know the sources of your information, so be sure to include at least two peer-reviewed sources. You may use the suggested resources for this assessment. Your citations and references do need to conform to APA guidelines.