Medical Errors And Patient Safety

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To Err Is Human

Author : Institute of Medicine,Committee on Quality of Health Care in America
Publisher : National Academies Press
Page : 312 pages
File Size : 48,9 Mb
Release : 2000-03-01
Category : Medical
ISBN : 9780309068376

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To Err Is Human by Institute of Medicine,Committee on Quality of Health Care in America Pdf

Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine

Advances in Patient Safety

Author : Kerm Henriksen
Publisher : Unknown
Page : 526 pages
File Size : 44,7 Mb
Release : 2005
Category : Medical
ISBN : CHI:70548902

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Advances in Patient Safety by Kerm Henriksen Pdf

v. 1. Research findings -- v. 2. Concepts and methodology -- v. 3. Implementation issues -- v. 4. Programs, tools and products.

Patient Safety and Quality

Author : Ronda Hughes
Publisher : Department of Health and Human Services
Page : 592 pages
File Size : 47,7 Mb
Release : 2008
Category : Medical
ISBN : IOWA:31858055672798

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Patient Safety and Quality by Ronda Hughes Pdf

"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/

Preventing Medication Errors

Author : Institute of Medicine,Board on Health Care Services,Committee on Identifying and Preventing Medication Errors
Publisher : National Academies Press
Page : 481 pages
File Size : 41,5 Mb
Release : 2007-01-11
Category : Medical
ISBN : 9780309101479

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Preventing Medication Errors by Institute of Medicine,Board on Health Care Services,Committee on Identifying and Preventing Medication Errors Pdf

In 1996 the Institute of Medicine launched the Quality Chasm Series, a series of reports focused on assessing and improving the nation's quality of health care. Preventing Medication Errors is the newest volume in the series. Responding to the key messages in earlier volumes of the seriesâ€"To Err Is Human (2000), Crossing the Quality Chasm (2001), and Patient Safety (2004)â€"this book sets forth an agenda for improving the safety of medication use. It begins by providing an overview of the system for drug development, regulation, distribution, and use. Preventing Medication Errors also examines the peer-reviewed literature on the incidence and the cost of medication errors and the effectiveness of error prevention strategies. Presenting data that will foster the reduction of medication errors, the book provides action agendas detailing the measures needed to improve the safety of medication use in both the short- and long-term. Patients, primary health care providers, health care organizations, purchasers of group health care, legislators, and those affiliated with providing medications and medication- related products and services will benefit from this guide to reducing medication errors.

After the Error

Author : Susan B. McIver,,Robin Wyndham,
Publisher : ECW Press
Page : 306 pages
File Size : 43,7 Mb
Release : 2013-05-09
Category : Health & Fitness
ISBN : 9781770903586

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After the Error by Susan B. McIver,,Robin Wyndham, Pdf

In a series of true stories from across Canada, this collection seeks to point out the considerable human toll that medical errors cause. Victims of medical errors and their families who speak out often do so at considerable emotional, psychological, and financial expense. But their willingness to share their harrowing stories has helped to lay the foundation for numerous patient safety programs and continues to identify problems, provide solutions, and raise awareness. These emotional and moving stories underline serious issues with medical errors while empowering patients.

Medical Error and Patient Safety

Author : George A. Peters,Barbara J. Peters
Publisher : CRC Press
Page : 256 pages
File Size : 47,6 Mb
Release : 2019-09-19
Category : Medical errors
ISBN : 0367388391

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Medical Error and Patient Safety by George A. Peters,Barbara J. Peters Pdf

A difficult and recalcitrant phenomenon, medical error causes pervasive and expensive problems in terms of patient injury, ineffective treatment, and rising healthcare costs. Simple heightened awareness can help, but it requires organized, effective remedies and countermeasures that are reasonable, acceptable, and adaptable to see a truly significant drop in the intolerable rate of medical mistakes. Only with better understanding, knowledge, and directed techniques can there be rapid and marked improvement in medical error management discipline. Since medical error is situation specific and involves diverse variables in equipment, environment, and human performance, the correct choice of preventive and corrective techniques is critical. Providing a wealth of useful ideas, concepts, and techniques, Medical Error and Patient Safety: Human Factors in Medicine uses abroad perspective to present more than 500 remedies that can be applied and tailored to your unique circumstances. This detailed review of so many measures enables you to correctly identify needs and undertake appropriate actions to achieve a success that can be measured in avoided injuries, improved healthcare, and reduced cost. Thought provoking and useful, this book considers the potential for error and the possibility for improvement in every aspect of healthcare. After an introduction to general concepts and approaches, it examines vulnerabilities in medical services, including emergency services, healthcare facilities, and infection control. It covers risks in medical devices and product design; human factors such as fatigue and stress; management errors; errors in communication at all levels of the healthcare hierarchy; as well as mistakes in drug delivery including faulty labels and warnings. The authors also compare and contrast several analytical methods, their interpretation, and their translation into a plan of action.

Patient Safety in Emergency Medicine

Author : Pat Croskerry,Karen S. Cosby
Publisher : Lippincott Williams & Wilkins
Page : 456 pages
File Size : 41,6 Mb
Release : 2009
Category : Medical
ISBN : 0781777275

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Patient Safety in Emergency Medicine by Pat Croskerry,Karen S. Cosby Pdf

With the increased emphasis on reducing medical errors in an emergency setting, this book will focus on patient safety within the emergency department, where preventable medical errors often occur. The book will provide both an overview of patient safety within health care—the 'culture of safety,' importance of teamwork, organizational change—and specific guidelines on issues such as medication safety, procedural complications, and clinician fatigue, to ensure quality care in the ED. Special sections discuss ED design, medication safety, and awareness of the 'culture of safety.'

Impact of Medical Errors and Malpractice on Health Economics, Quality, and Patient Safety

Author : Riga, Marina
Publisher : IGI Global
Page : 334 pages
File Size : 54,6 Mb
Release : 2017-01-30
Category : Medical
ISBN : 9781522523383

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Impact of Medical Errors and Malpractice on Health Economics, Quality, and Patient Safety by Riga, Marina Pdf

Precise and flawless medical practice is imperative due to the delicate nature of patient lives and health. Without methods and technologies to detect medical mistakes, many lives would be compromised. Impact of Medical Errors and Malpractice on Health Economics, Quality, and Patient Safety is an essential reference source for the latest research on the detection and analysis of the various implications of medical errors and addresses the hidden malpractices that exist in healthcare systems globally. Featuring extensive coverage on a broad range of topics such as clinical pathways, decision-making techniques, and health information technology, this book is ideally designed for practitioners, professionals, and researchers seeking current research on various issues in healthcare provision.

Textbook of Patient Safety and Clinical Risk Management

Author : Liam Donaldson,Walter Ricciardi,Susan Sheridan,Riccardo Tartaglia
Publisher : Springer Nature
Page : 496 pages
File Size : 49,7 Mb
Release : 2020-12-14
Category : Medical
ISBN : 9783030594039

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Textbook of Patient Safety and Clinical Risk Management by Liam Donaldson,Walter Ricciardi,Susan Sheridan,Riccardo Tartaglia Pdf

Implementing safety practices in healthcare saves lives and improves the quality of care: it is therefore vital to apply good clinical practices, such as the WHO surgical checklist, to adopt the most appropriate measures for the prevention of assistance-related risks, and to identify the potential ones using tools such as reporting & learning systems. The culture of safety in the care environment and of human factors influencing it should be developed from the beginning of medical studies and in the first years of professional practice, in order to have the maximum impact on clinicians' and nurses' behavior. Medical errors tend to vary with the level of proficiency and experience, and this must be taken into account in adverse events prevention. Human factors assume a decisive importance in resilient organizations, and an understanding of risk control and containment is fundamental for all medical and surgical specialties. This open access book offers recommendations and examples of how to improve patient safety by changing practices, introducing organizational and technological innovations, and creating effective, patient-centered, timely, efficient, and equitable care systems, in order to spread the quality and patient safety culture among the new generation of healthcare professionals, and is intended for residents and young professionals in different clinical specialties.

Making Healthcare Safe

Author : Lucian L. Leape
Publisher : Springer Nature
Page : 450 pages
File Size : 53,5 Mb
Release : 2021-05-28
Category : Medical
ISBN : 9783030711238

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Making Healthcare Safe by Lucian L. Leape Pdf

This unique and engaging open access title provides a compelling and ground-breaking account of the patient safety movement in the United States, told from the perspective of one of its most prominent leaders, and arguably the movement’s founder, Lucian L. Leape, MD. Covering the growth of the field from the late 1980s to 2015, Dr. Leape details the developments, actors, organizations, research, and policy-making activities that marked the evolution and major advances of patient safety in this time span. In addition, and perhaps most importantly, this book not only comprehensively details how and why human and systems errors too often occur in the process of providing health care, it also promotes an in-depth understanding of the principles and practices of patient safety, including how they were influenced by today’s modern safety sciences and systems theory and design. Indeed, the book emphasizes how the growing awareness of systems-design thinking and the self-education and commitment to improving patient safety, by not only Dr. Leape but a wide range of other clinicians and health executives from both the private and public sectors, all converged to drive forward the patient safety movement in the US. Making Healthcare Safe is divided into four parts: I. In the Beginning describes the research and theory that defined patient safety and the early initiatives to enhance it. II. Institutional Responses tells the stories of the efforts of the major organizations that began to apply the new concepts and make patient safety a reality. Most of these stories have not been previously told, so this account becomes their histories as well. III. Getting to Work provides in-depth analyses of four key issues that cut across disciplinary lines impacting patient safety which required special attention. IV. Creating a Culture of Safety looks to the future, marshalling the best thinking about what it will take to achieve the safe care we all deserve. Captivatingly written with an “insider’s” tone and a major contribution to the clinical literature, this title will be of immense value to health care professionals, to students in a range of academic disciplines, to medical trainees, to health administrators, to policymakers and even to lay readers with an interest in patient safety and in the critical quest to create safe care.

Patient Safety Ethics

Author : John D. Banja
Publisher : Johns Hopkins University Press
Page : 273 pages
File Size : 44,7 Mb
Release : 2019-06-25
Category : Medical
ISBN : 9781421429083

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Patient Safety Ethics by John D. Banja Pdf

Providing professional perspective with insights from prominent patient safety experts, Patient Safety Ethics identifies hazard pitfalls and suggests concrete ways for clinicians and regulators to improve patient safety through an ethically cultivated program of "hazard awareness."

Resident Duty Hours

Author : Institute of Medicine,Committee on Optimizing Graduate Medical Trainee (Resident) Hours and Work Schedules to Improve Patient Safety
Publisher : National Academies Press
Page : 427 pages
File Size : 47,7 Mb
Release : 2009-04-27
Category : Medical
ISBN : 9780309131520

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Resident Duty Hours by Institute of Medicine,Committee on Optimizing Graduate Medical Trainee (Resident) Hours and Work Schedules to Improve Patient Safety Pdf

Medical residents in hospitals are often required to be on duty for long hours. In 2003 the organization overseeing graduate medical education adopted common program requirements to restrict resident workweeks, including limits to an average of 80 hours over 4 weeks and the longest consecutive period of work to 30 hours in order to protect patients and residents from unsafe conditions resulting from excessive fatigue. Resident Duty Hours provides a timely examination of how those requirements were implemented and their impact on safety, education, and the training institutions. An in-depth review of the evidence on sleep and human performance indicated a need to increase opportunities for sleep during residency training to prevent acute and chronic sleep deprivation and minimize the risk of fatigue-related errors. In addition to recommending opportunities for on-duty sleep during long duty periods and breaks for sleep of appropriate lengths between work periods, the committee also recommends enhancements of supervision, appropriate workload, and changes in the work environment to improve conditions for safety and learning. All residents, medical educators, those involved with academic training institutions, specialty societies, professional groups, and consumer/patient safety organizations will find this book useful to advocate for an improved culture of safety.

Understanding Patient Safety, Second Edition

Author : Robert Wachter
Publisher : McGraw Hill Professional
Page : 501 pages
File Size : 52,5 Mb
Release : 2012-05-23
Category : Medical
ISBN : 9780071808125

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Understanding Patient Safety, Second Edition by Robert Wachter Pdf

Complete coverage of the core principles of patient safety Understanding Patient Safety, 2e is the essential text for anyone wishing to learn the key clinical, organizational, and systems issues in patient safety. The book is filled with valuable cases and analyses, as well as up-to-date tables, graphics, references, and tools -- all designed to introduce the patient safety field to medical trainees, and be the go-to book for experienced clinicians and non-clinicians alike. Features NEW chapter on the critically important role of checklists in medical practice NEW case examples throughout Expanded coverage of the role of computers in patient safety and outcomes Expanded coverage of new patient initiatives from the Joint Commission

Talking with Patients and Families about Medical Error

Author : Robert D. Truog,David M. Browning,Judith A. Johnson,Thomas H. Gallagher
Publisher : JHU Press
Page : 198 pages
File Size : 49,8 Mb
Release : 2011-01-17
Category : Medical
ISBN : 9781421401027

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Talking with Patients and Families about Medical Error by Robert D. Truog,David M. Browning,Judith A. Johnson,Thomas H. Gallagher Pdf

More than a million patient safety incidents occur every year, and medical error is the third leading cause of death in the United States. Illuminating the experiences of those affected by medical error—patients, their loved ones, and physicians and other medical professionals—Talking with Patients and Families about Medical Error delves deeply into the challenges of communicating honestly and openly about mistakes in medical practice. cc Based on guidelines from the Institute for Professional and Ethical Practice and the authors' own experiences, the practice-based approaches outlined here offer concrete guidance on • initiating discussions • dealing professionally and compassionately with patients' reactions • who should be included in the conversation • what information should be documented in the medical record • how to respond to questions about financial compensation Aimed at promoting resolution and healing, this book stresses the importance of clear, empathetic communication that will improve clinical and organizational responses to medical missteps and mismanagement. It emphasizes five features of the physician-patient relationship deserving of special attention: transparency, respect, accountability, continuity, and kindness (TRACK). Narrative examples of common situations demonstrate how conversations about medical error can lead to healing.

Still Not Safe

Author : Robert Wears
Publisher : Oxford University Press, USA
Page : 305 pages
File Size : 46,7 Mb
Release : 2019-12
Category : Medical
ISBN : 9780190271268

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Still Not Safe by Robert Wears Pdf

The term "patient safety" rose to popularity in the late nineties, as the medical community -- in particular, physicians working in nonmedical and administrative capacities -- sought to raise awareness of the tens of thousands of deaths in the US attributed to medical errors each year. But what was causing these medical errors? And what made these accidents to rise to epidemic levels, seemingly overnight? Still Not Safe is the story of the rise of the patient-safety movement -- and how an "epidemic" of medical errors was derived from a reality that didn't support such a characterization. Physician Robert Wears and organizational theorist Kathleen Sutcliffe trace the origins of patient safety to the emergence of market trends that challenged the place of doctors in the larger medical ecosystem: the rise in medical litigation and physicians' aversion to risk; institutional changes in the organization and control of healthcare; and a bureaucratic movement to "rationalize" medical practice -- to make a hospital run like a factory. If these social factors challenged the place of practitioners, then the patient-safety movement provided a means for readjustment. In spite of relatively constant rates of medical errors in the preceding decades, the "epidemic" was announced in 1999 with the publication of the Institute of Medicine report To Err Is Human; the reforms that followed came to be dominated by the very professions it set out to reform. Weaving together narratives from medicine, psychology, philosophy, and human performance, Still Not Safe offers a counterpoint to the presiding, doctor-centric narrative of contemporary American medicine. It is certain to raise difficult, important questions around the state of our healthcare system -- and provide an opening note for other challenging conversations.