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Medical Error – Recognition, Reporting, Managing Response, and Limiting Harm
Published in John W. Overton, Eileen Frazer, Safety and Quality in Medical Transport Systems, 2019
Gregory H. Botz, John W. Crommett
Many health care organizations depend on financial databases as the source for such inquiries. Such databases lack focus on clinical process data elements. It is also important to recognize that most medical errors do not represent negligence or tort-based malpractice; most identified medical errors do not result in direct patient harm. These “near misses” are equally important to recognize and mitigate. The National Patient Safety Foundation (2010) considers the establishment of a medical culture of safety as foundational to preventing medical errors. Such a culture of safety must empower all members to recognize and report such medical errors and “near misses” that jeopardize patient safety without fear of retribution or threat to professional standing. Medical errors should be detected and examined systematically to understand how they occur, and to devise error prevention strategies to limit further or future harm. This philosophy falls in line with Reason’s basic steps to dealing with errors in high-reliability organizations: identify, prevent, and absorb (Reason 2000). If this sounds familiar, it is most certainly similar to the challenges faced by the commercial aviation industry during the last 50 years. Patient safety and health care delivery improvement strategies have been significantly influenced by the lessons learned in aviation.
Reliability and Human Error in Systems
Published in Robert W. Proctor, Van Zandt Trisha, Human Factors in Simple and Complex Systems, 2018
Robert W. Proctor, Van Zandt Trisha
Despite the increased awareness of the importance of reducing medical error, Leape and Berwick (2005) concluded that progress had been “frustratingly slow” (p. 2385), with deaths from medical errors reduced only slightly by 2005. Recent estimates of the number of error-related deaths put the figure now at 400,000 per year, considerably greater than the estimate in 2000 (James, 2013; McCann, 2014), suggesting that medical error is now the third leading cause of death in the United States. This high rate of medical error contributes to the U.S.’s low health system ranking among those of other developed countries (Davis, Stremikis, Squires, &Schoen, 2014). Pleas for additional research and education on medical human factors have been made, for example, in the areas of surgical teams (Kurmann et al., 2012) and resuscitation teams (Norris & Lockey, 2012). One area that is particularly in need of examination is the design and use of information technology for electronic health records (EHRs), which may be based on outdated or poorly designed software. Design deficiencies and poor usability of EHRs are directly responsible for a number of high-profile medical errors (Sawchuk, Linville, Cornish et al., 2014).
Future Trends in Human Factors
Published in Nancy J. Stone, Chaparro Alex, Joseph R. Keebler, Barbara S. Chaparro, Daniel S. McConnell, Introduction to Human Factors, 2017
Nancy J. Stone, Chaparro Alex, Joseph R. Keebler, Barbara S. Chaparro, Daniel S. McConnell
Recent research shows medical errors are the third leading cause of death in the United States (Makary & Daniel, 2016). Since the Institutes of Medicine (IOM) report in 1999, the number has steadily increased—from less than 100,000 medical error-related deaths to almost half a million (Makary & Daniel, 2016). The reason behind this increase in errors is still unclear. The simplest explanation is that more errors are occurring. If we use our human factors way of thinking, it’s more likely that instead we may be getting better at measuring errors, or we are uncovering more errors as we investigate them in this setting. Regardless, the integration of human factors into healthcare has begun and seems to be here to stay. Human factors can be applied to the medical setting in a multitude of ways—from the design of the electronic devices and interfaces that practitioners need to interact with on a daily basis, to the redesign of workflow, team practices, protocols, and checklists. Owing to the need for error mitigation and prevention (see Chapter 11), human factors is being applied across the medical setting, including inpatient and outpatient settings. Although HF/E has a multitude of approaches at its disposal, there appear to be only four ways in which HF/E can actually intervene in this setting—changing the equipment, changing the training, changing the procedures, or changing the organization (Stanton, 2005). We discuss the various ways HF/E can be applied to the medical domain with these four intervention strategies as the basis for application.
The effect of personal protective equipment use on nurses’ tendencies to make medical errors and types of their medical errors: a cross-sectional study
Published in International Journal of Occupational Safety and Ergonomics, 2023
Cennet Çiriş Yildiz, Dilek Yildirim, Kardelen Günay
Information on the types and prevalence of medical errors made while providing nursing care in the last year is presented in Table 2. The most commonly encountered medical errors in the hospital where the nurses were working were, respectively, needle/scissor injuries, hospital infections, bedsores, fatal or damaging falls, infusion pump errors, confusing acronyms/abbreviations for drug and procedure names, and wrong-dose drug administration (Table 2). As a result of the χ2 analysis carried out to detect whether the types of medical errors examined in the study differed based on the types of PPE used by the participants, it was determined that the relationship between the type of PPE used and making the mistake of applying the wrong dose of medication was significant (p < 0.05), and there was no statistically significant difference in terms of the other error types (p > 0.05) (Table 3).
Measuring the Influence of Service Quality on Patient Satisfaction in Malaysia
Published in Quality Management Journal, 2019
Christine Nya-Ling Tan, Adedapo Oluwaseyi Ojo, Jun-Hwa Cheah, T. Ramayah
The healthcare industry is unique for the emphasis the patients place on high-quality services. The patient’s perception of service quality is critical to the healthcare provider’s long-term success. As noted by Stock, McFadden, and Gowen (2010), healthcare quality crossroads are decisions that seek to deliver and balance the right care, at the right time, at the right cost, and in the right place. Thus, by recognizing and understanding the factors that drive patients’ expectations, the healthcare providers are better positioned to exceed the demand for high-quality services from well-informed patients. Also, the balance between efficiency and quality of care in healthcare is vital, as it affects patient safety, life and death, and long-term health (Gardner, Linderman, and McFadden 2018). A minor error or misjudgement can result in a fatal outcome. MacDonald (2013) revealed that medical errors account for the death of about 98,000 people annually in U.S. hospitals, while Allen (2013) reported that between 210,000 to 400,000 deaths are recorded annually in U.S. hospitals due to preventable adverse events. Therefore, service quality is of prime importance to the managers in the healthcare industry.