Error and Accountability

2019 ◽  
pp. 75-112
Author(s):  
Michael A. Bruno
Keyword(s):  
Peer Review ◽  
Regulatory Compliance ◽  
Ethical Aspects ◽  
Just Culture ◽  
Open Disclosure ◽  
Ethical Duty ◽  
Culture Models ◽  
Organizational Accountability

In this chapter we will explore the issues related to individual and organizational accountability for error, particularly when a patient suffers harm that is attributable to physician error. We will review the blameless culture and “just culture” models, as well as related issues of peer-review, regulatory compliance, medicolegal, and ethical aspects of error in this context. We will discuss the ethical duty to provide open disclosure of all errors and lapses directly to patients and their families, regardless of cause (and separated from the issue of blame) and in some circumstances coupled with financial or other compensation for any harm done.

Just Culture: Practical Implementation for Radiologist Peer Review

2019 ◽  
Vol 16 (3) ◽  
pp. 384-388 ◽  
Author(s):  
Judah Burns ◽  
Todd Miller ◽  
Jeffrey M. Weiss ◽  
Amichai Erdfarb ◽  
David Silber ◽  
...  
Keyword(s):  
Peer Review ◽  
Practical Implementation ◽  
Just Culture

scholarly journals Reviewing articles as a way of professional evaluation of scientific texts: organizational and ethical aspects

2020 ◽  
Vol 4 (1) ◽  
pp. 26-36
Author(s):  
Svitlana Fiialka ◽  
Olga Trishchuk ◽  
Nadija Figol
Keyword(s):  
Higher Education ◽  
Peer Review ◽  
Conflicts Of Interest ◽  
Scientific Journals ◽  
Ethical Aspects ◽  
Double Blind ◽  
Scientific Texts ◽  
Peer Reviewing ◽  
Professional Evaluation ◽  
Single Blind

The purpose of the paper is to summarize the organizational and ethical aspects, problems and prospects of peer reviewing. To do this, from September 2019 to January 2020, a survey of Ukrainian scientists registered in Facebook groups “Ukrainian Scientific Journals”, “Ukrainian Scientists Worldwide”, “Pseudoscience News in Ukraine”, “Higher Education and Science of Ukraine: Decay or Blossom?” and others was conducted. In total, 390 researchers from different disciplines participated in the survey. The results of the survey are following: 8.7% of respondents prefer open peer review, 43.1% – single-blind, 37.7% – double blind, 9.2% – triple blind, 1.3% used to sign a review prepared by the author. 75.6% of respondents had conflicts of interest during peer reviewing. 8.2 % of reviewers never reject articles regardless of their quality. Because usually only editors and authors see reviews, it can lead to the following issues: reviewers can be rude or biased; authors may not adequately respond to grounded criticism; editors may disregard the position of the author or reviewer, and journals may charge for publishing articles without proper peer review.

Institution of Just Culture Physician Peer Review in an Academic Medical Center

2017 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Judith K. Volkar ◽  
Paul Phrampus ◽  
Dennis English ◽  
Ronald Johnson ◽  
Ashley Medeiros ◽  
...  
Keyword(s):  
Peer Review ◽  
Medical Center ◽  
Academic Medical Center ◽  
Just Culture ◽  
Academic Medical

Ethical Issues in Psychotherapy of Other Therapists: Description, Considerations, and Ways of Coping

2020 ◽  
Author(s):  
Gaby Shefler ◽  
Shai Lederman ◽  
Refael Yonatan-Leus
Keyword(s):  
Ethical Issues ◽  
Professional Community ◽  
Professional Organizations ◽  
Professional Roles ◽  
Multiple Relationships ◽  
Ethical Aspects ◽  
Ways Of Coping ◽  
Ethical Duty ◽  
Ethical Violations ◽  
Illegal Behavior

What are the specific ethical aspects of psychotherapy with patients who are themselves therapists (patient-therapists)? This chapter argues that the main difference between psychotherapy with patient-therapists and non-therapist patients is that in the former, the therapist is both the patient’s therapist and colleague. Potential multiple relationships may arise in such cases since the therapist and the patient are both members of the same professional community. In addition, therapists are faced with the challenges of maintaining boundaries between the therapeutic and other professional roles. The most complex dilemma in this situation concerns the therapist’s duty to report patient-therapists’ professional impairment, incompetency, ethical violations, or suspected illegal behavior. The authors suggest that the therapist’s primary ethical duty in this case is to the patient and that reporting should only be as a last resort. The chapter concludes with a call to professional organizations and other regulating bodies for establishing guidelines for managing such dilemmas.

A Physician's Exposure to Defamation

1992 ◽  
Vol 7 (1) ◽  
pp. 30-33
Author(s):  
William J. Mandell
Keyword(s):  
Peer Review ◽  
Review Process ◽  
Peer Review Process ◽  
Good Faith ◽  
Ethical Duty

The article defines defamation, discusses how to avoid a defamation action, and suggests defenses against a defamation action. Several examples are given that demonstrate common situations where liability exists and how a physician should respond. The article explains that at times we have a duty to speak and differentiates between our legal, moral, and ethical duty. Defamation should not be a concern for those involved in the peer review process, as long as they are truthful or act in a good faith belief that what they are saying is true. The article should enhance peer review by encouraging physicians to participate without fear of a retaliatory law suit.

Incorporating Peer Learning Into Your Breast Imaging Practice

2021 ◽  
Author(s):  
Leah E Schafer ◽  
Hannah Perry ◽  
Michael DC Fishman ◽  
Bernadette V Jakomin ◽  
Priscilla J Slanetz
Keyword(s):  
Breast Cancer ◽  
Artificial Intelligence ◽  
Patient Care ◽  
Peer Review ◽  
Breast Imaging ◽  
Peer Learning ◽  
Learning Model ◽  
Learning Opportunities ◽  
Just Culture

Abstract Traditional score-based peer review has come under scrutiny in recent years, as studies have demonstrated it to be generally ineffective at improving quality. Many practices and programs are transitioning to a peer learning model to replace or supplement traditional peer review. Peer learning differs from traditional score-based peer review in that the emphasis is on sharing learning opportunities and creating an environment that fosters discussion of errors in a nonpunitive forum with the goal of improved patient care. Creating a just culture is central to fostering successful peer learning. In a just culture, mistakes can be discussed without shame or fear of retribution and the focus is on systems improvement rather than individual blame. Peer learning, as it pertains to breast imaging, can occur in many forms and venues. Examples of the various formats in which peer learning can occur include through individual colleague interaction, as well as divisional, multidisciplinary, department-wide, and virtual conferences, and with the assistance of artificial intelligence. Incorporating peer learning into the practice of breast imaging aims to reduce delayed diagnoses of breast cancer and optimize patient care.

An Assessment of the Impact of Just Culture on Quality and Safety in US Hospitals

2018 ◽  
Vol 33 (5) ◽  
pp. 502-508 ◽  
Author(s):  
Marc T. Edwards
Keyword(s):  
Peer Review ◽  
Positive Impact ◽  
Peer Review Process ◽  
High Reliability ◽  
Patient Safety Culture ◽  
Hospital Performance ◽  
Healthcare Research ◽  
Just Culture ◽  
Hospital Compare ◽  
The Impact

In pursuit of high reliability, numerous organizations have promoted Just Culture, but its impact has never been assessed. This report combines data from a longitudinal survey–based study of clinical peer review practices in a cohort of 457 acute care hospitals with 43 measures from the Hospital Compare database and interprets them in relation to the long-term trends of Agency for Healthcare Research and Quality (AHRQ) data on the Hospital Survey of Patient Safety Culture. In all, 211 of 270 respondents (79%) indicated that their hospital has adopted Just Culture. More than half believe that it has had a positive impact. Just Culture implementation and its degree of impact are associated with somewhat better peer review process, but not with objective measures of hospital performance. Non-Punitive Response to Error has consistently been the lowest scoring category (45% positive) in the AHRQ database. Widespread adoption of Just Culture has not reduced reluctance to report or the culture of blame it targets.

On visions and promises — ethical aspects of in vitro meat

2019 ◽  
Vol 3 (6) ◽  
pp. 753-758
Author(s):  
Silvia Woll
Keyword(s):  
Animal Welfare ◽  
Environmental Issues ◽  
Meat Production ◽  
Ethical Aspects ◽  
Existing Problems ◽  
In Vitro Meat ◽  
Production And Consumption ◽  
Production Conditions

Innovators of in vitro meat (IVM) are convinced that this approach is the solution for problems related to current meat production and consumption, especially regarding animal welfare and environmental issues. However, the production conditions have yet to be fully clarified and there is still a lack of ethical discourses and critical debates on IVM. In consequence, discussion about the ethical justifiability and desirability of IVM remains hypothetical and we have to question those promises. This paper addresses the complex ethical aspects associated with IVM and the questions of whether, and under what conditions, the production of IVM represents an ethically justifiable solution for existing problems, especially in view of animal welfare, the environment, and society. There are particular hopes regarding the benefits that IVM could bring to animal welfare and the environment, but there are also strong doubts about their ethical benefits.

Communication Disordered: Program Implementation in Long-Term Care

2016 ◽  
Vol 1 (15) ◽  
pp. 64-67
Author(s):  
George Barnes ◽  
Joseph Salemi
Keyword(s):  
Program Implementation ◽  
Long Term Care ◽  
Family Satisfaction ◽  
Regulatory Compliance ◽  
Care Staff ◽  
Term Care ◽  
Staff Members ◽  
Change Policy

The organizational structure of long-term care (LTC) facilities often removes the rehab department from the interdisciplinary work culture, inhibiting the speech-language pathologist's (SLP's) communication with the facility administration and limiting the SLP's influence when implementing clinical programs. The SLP then is unable to change policy or monitor the actions of the care staff. When the SLP asks staff members to follow protocols not yet accepted by facility policy, staff may be unable to respond due to confusing or conflicting protocol. The SLP needs to involve members of the facility administration in the policy-making process in order to create successful clinical programs. The SLP must overcome communication barriers by understanding the needs of the administration to explain how staff compliance with clinical goals improves quality of care, regulatory compliance, and patient-family satisfaction, and has the potential to enhance revenue for the facility. By taking this approach, the SLP has a greater opportunity to increase safety, independence, and quality of life for patients who otherwise may not receive access to the appropriate services.

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