Involuntary automaticity: a work-system induced risk to safe health care

2005 ◽  
Vol 18 (4) ◽  
pp. 211-216 ◽  
Author(s):  
Brian Toft ◽  
Hugo Mascie-Taylor
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Health Care Professionals ◽  
Health Care Organizations ◽  
Negative Effects ◽  
Care Community ◽  
Work System ◽  
Skilled Action ◽  
Conscious Attention

Automaticity is the term given by psychologists to the skilled action that people develop through repeatedly practising the same activity, for example driving a car. Usually, automaticity is discussed in terms of the benefits it brings to people, such as the reduction in the degree of conscious attention a person needs to pay to such skilled activities. However, there is evidence to suggest that substantial costs may also be associated with such learned behaviour. Managing patient safety is a difficult task and one of the ways in which health-care professionals seek to accomplish it is through the use of verbal challenge-response protocols. However, it is argued in this paper that it is possible for the negative effects of automaticity to involuntarily capture those using such verbal checklist techniques and cause them to erroneously believe that the treatment that they are about to administer to a patient is safe when it is not. This phenomenon does not, however, seem to have been recognized by the health-care community nationally or internationally. We conclude that patient safety could be significantly improved worldwide if the organizational arrangements which appear to induce involuntary automaticity were to be robustly addressed by the management of all health-care organizations.

Are Communities Willing to Transition Into Learning Health Care Communities? A Community-Based Participatory Evaluation of Stakeholders’ Receptivity

2021 ◽  
pp. 104973232199864
Author(s):  
Nabil Natafgi ◽  
Olayinka Ladeji ◽  
Yoon Duk Hong ◽  
Jacqueline Caldwell ◽  
C. Daniel Mullins
Keyword(s):  
Health Care ◽  
Health Care Delivery ◽  
Health Care Professionals ◽  
Care Delivery ◽  
Lessons Learned ◽  
Community Members ◽  
Community Based ◽  
Care Community ◽  
Care Experience ◽  
National Initiative

This article aims to determine receptivity for advancing the Learning Healthcare System (LHS) model to a novel evidence-based health care delivery framework—Learning Health Care Community (LHCC)—in Baltimore, as a model for a national initiative. Using community-based participatory, qualitative approach, we conducted 16 in-depth interviews and 15 focus groups with 94 participants. Two independent coders thematically analyzed the transcripts. Participants included community members (38%), health care professionals (29%), patients (26%), and other stakeholders (7%). The majority considered LHCC to be a viable model for improving the health care experience, outlining certain parameters for success such as the inclusion of home visits, presentation of research evidence, and incorporation of social determinants and patients’ input. Lessons learned and challenges discussed by participants can help health systems and communities explore the LHCC aspiration to align health care delivery with an engaged, empowered, and informed community.

Development of the perceptions of preventable adverse events assessment tool (PPAEAT): measurement properties and patients’ mental health status

2021 ◽  
Vol 33 (2) ◽  
Author(s):  
Franziska Maria Keller ◽  
Christina Derksen ◽  
Lukas Kötting ◽  
Martina Schmiedhofer ◽  
Sonia Lippke
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Patient Safety ◽  
Primary Health Care ◽  
Adverse Events ◽  
Health Care Professionals ◽  
Discriminant Validity ◽  
Assessment Tool ◽  
Primary Health ◽  
Item Scale

Abstract Background Patient-centered care and patient involvement have been increasingly recognized as crucial elements of patient safety. However, patient safety has rarely been evaluated from the patient perspective with a quantitative approach aiming at making patient safety and preventable adverse events measurable. Objectives The objectives of this study were to develop and evaluate the psychometric properties of a questionnaire assessing patient safety by perceived triggers of preventable adverse events among patients in primary health-care settings while considering mental health. Methods Two hundred and ten participants were recruited through various digital and print channels and asked to complete an online survey between November 2019 and April 2020. Exploratory factor analysis was performed to identify domains of triggers of preventable adverse events affecting patient safety. Furthermore, a multi-trait scaling analysis was performed to evaluate internal reliability as well as item-scale convergent–discriminant validity. A multivariate analysis of covariance evaluated whether individuals below and above the symptom threshold for depression and generalized anxiety perceive triggers of preventable adverse events differently. Results The five factors determined were information and communication with patients, time constraints of health-care professionals, diagnosis and treatment, hygiene and communication among health-care professionals, and knowledge and operational procedures. The questionnaire demonstrated a good total and subscale internal consistency (α = 0.90, range = 0.75–0.88), good item-scale convergent validity with significant correlations between 0.57 and 0.78 (P < 0.05; P < 0.01) for all items with their associated subscales, and satisfactory item-scale discriminant validity between 0.14 and 0.55 (P > 0.05) with no significant correlations between the items and their competing subscales. The questionnaire further revealed to be a generic measure irrespective of patients’ mental health status. Patients older than 50 years of age perceived a significantly greater threat to their own safety compared to patients below that age. Conclusion The developed Perceptions of Preventable Adverse Events Assessment Tool (PPAEAT) exhibits good psychometric properties, which supports its use in future research and primary health-care practice. Further validation of the PPAEAT in different settings, languages and larger samples is needed. The results of this study need to be considered when assessing patient safety in the context of health-care research.

scholarly journals Bedside Nurse Acceptance of Intensive Care Unit Telemedicine Presence

2018 ◽  
Vol 38 (6) ◽  
pp. e1-e4 ◽  
Author(s):  
Christina Canfield ◽  
Sandra Galvin
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Nurse Practitioners ◽  
Health Care Professionals ◽  
Health Care Organizations ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
Perception Of Support ◽  
Evidence Based Care

Since 2010, health care organizations have rapidly adopted telemedicine as part of their health care delivery system to inpatients and outpatients. The application of telemedicine in the intensive care unit is often referred to as tele-ICU. In telemedicine, nurses, nurse practitioners, physicians, and other health care professionals provide patient monitoring and intervention from a remote location. Tele-ICU presence has demonstrated positive outcomes such as increased adherence to evidence-based care and improved perception of support at the bedside. Despite the successes, acceptance of tele-ICU varies. Known barriers to acceptance include perceptions of intrusiveness and invasion of privacy.

scholarly journals How Women Evaluate Birth Challenges: Analysis of Web-Based Birth Stories (Preprint)

2018 ◽  
Author(s):  
Yasmine L Konheim-Kalkstein ◽  
Talya Miron-Shatz ◽  
Leah Jenny Israel
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Positive Emotions ◽  
Fisher Exact Test ◽  
Labor And Delivery ◽  
Care Providers ◽  
Birth Stories ◽  
Care Community ◽  
Emotional Appraisal

BACKGROUND Birth stories provide an intimate glimpse into women’s birth experiences in their own words. Understanding the emotions elicited in women by certain types of behaviors during labor and delivery could help those in the health care community provide better emotional care for women in labor. OBJECTIVE The aim of this study was to understand which supportive reactions and behaviors contributed to negative or positive emotions among women with regard to their labor and delivery experience. METHODS We sampled 10 women’s stories from a popular blog that described births that strayed from the plan. Overall, 90 challenging events that occurred during labor and delivery were identified. Each challenge had an emotionally positive, negative, or neutral evaluation by the woman. We classified supportive and unsupportive behaviors in response to these challenges and examined their association with the woman’s emotional appraisal of the challenges. RESULTS Overall, 4 types of behaviors were identified: informational inclusion, decisional inclusion (mostly by health care providers), practical support, and emotional support (mostly by partners). Supportive reactions were not associated with emotional appraisal; however, unsupportive reactions were associated with women appraising the challenge negatively (Fisher exact test, P=.02). CONCLUSIONS Although supportive behaviors did not elicit any particular emotion, unsupportive behaviors did cause women to view challenges negatively. It is worthwhile conducting a larger scale investigation to observe what happens when patients express their needs, particularly when challenges present themselves during labor, and health care professionals strive to cater to them.

scholarly journals Surveillance, anticipation and firefighting: Perspectives of patient safety from a New Zealand case study

2020 ◽  
Author(s):  
J Wailling ◽  
Brian Robinson ◽  
M Coombs
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
New Zealand ◽  
Health Care Professionals ◽  
Nuclear Power ◽  
High Reliability ◽  
Health Care Systems ◽  
Tertiary Hospital ◽  
Structured Interviews

© 2018 John Wiley & Sons Ltd Aim: This study explored how doctors, nurses and managers working in a New Zealand tertiary hospital understand patient safety. Background: Despite health care systems implementing proven safety strategies from high reliability organisations, such as aviation and nuclear power, these have not been uniformly adopted by health care professionals with concerns raised about clinician engagement. Design: Instrumental, embedded case study design using qualitative methods. Methods: The study used purposeful sampling, and data was collected using focus groups and semi-structured interviews with doctors (n = 31); registered nurses (n = 19); and senior organisational managers (n = 3) in a New Zealand tertiary hospital. Results: Safety was described as a core organisational value. Clinicians appreciated proactive safety approaches characterized by anticipation and vigilance, where they expertly recognized and adapted to safety risks. Managers trusted evidence-based safety rules and approaches that recorded, categorized and measured safety. Conclusion and Implications for Nursing Management: It is important that nurse managers hold a more refined understanding about safety. Organisations are more likely to support safe patient care if cultural complexity is accounted for. Recognizing how different occupational groups perceive and respond to safety, rather than attempting to reinforce a uniform set of safety actions and responsibilities, is likely to bring together a shared understanding of safety, build trust and nurture safety culture.

scholarly journals Topical Issues of Criminal Liability of Medical or Pharmaceutical Workers under the Criminal Code of Ukraine (Article 140 of the Criminal Code of Ukraine)

2019 ◽  
Vol 8 (4S) ◽  
pp. 87-92
Keyword(s):  
Health Care ◽  
Human Rights ◽  
Patient Safety ◽  
Health Care Professionals ◽  
Criminal Liability ◽  
Complex Structure ◽  
Criminal Code ◽  
Professional Activity ◽  
Scientific Article ◽  
Political Processes

The issues of Improper protection of rights and legal interests of the patients due to improper performance of professional duties by a medical or pharmaceutical worker are considered. In particular, problems arising during the application of the norm of criminal liability for specified socially dangerous acts are considered. At the same time, cases of serious consequences to the patient's life and health due to a medical error or actions of medical or pharmaceutical workers committed in the absence of fault are considered although they result in the death of the patient or other grave consequences. Particular attention is paid to iatrogenic mental illness, caused by improper professional activity of the medical workers and peculiarities of the psyche of the patients. Particular attention is paid to the study of the practice of the European Court of Human Rights regarding the legal guarantee of the right to life in Ukraine in the context of criminal proceedings. Ukraine is a party to virtually all international human rights treaties. It imposes on it the obligation to adhere to European norms in the field of human protection. The need for comparative study of laws and effectiveness of their application at the present stage of society's development is due to the process of globalization affecting today not only economic and political processes but also the process of lawmaking. This requires the lawyers of different countries to join in the development of the theoretical foundations of lawmaking to formulate in the aggregate knowledge about the effect of laws based on world legal traditions and experience of the separate states. The complex structure of the health care organizations has led to the need for new models of healthcare professionals to ensure the quality of care and patient safety. In the current situation, patient safety is one of the new challenges faced by the medical students in undergraduate and postgraduate education. This involves incorporating a patient safety culture into curricula, in particular for the doctors and other health care professionals. The scientific article is aimed at solving the issues of criminal law protection as the rights of people in need of the medical services as well as medical and pharmaceutical workers who provide these services.

Klinkende meerstemmige verhalen, deel II

KWALON ◽  
2014 ◽  
Vol 19 (1) ◽  
Author(s):  
Monique Bussmann ◽  
Chris Kuiper ◽  
Alexander Maas
Keyword(s):  
Health Care ◽  
Labor Market ◽  
Data Collection ◽  
Health Care Professionals ◽  
Health Care Organizations ◽  
Elderly Care ◽  
Music Listening ◽  
Musical Work ◽  
Narrative Methodology ◽  
The Government

Sounding polyphonic stories, part II. The phase of listening in data collection Sounding polyphonic stories, part II. The phase of listening in data collection In the Netherlands, future staffing of elderly care will demand a big effort and a lot of creativity of health care organizations and the government. In this study an unconventional qualitative, narrative methodology is applied to throw a new light on the significance having a job and working in elderly care has for health care professionals and to use this as a source of inspiration for labor market policymakers. The methodology is rather unconventional because it doesn’t only focuses on the lingual content of the stories, but also includes other significant aspects of storytelling (e.g., voice and sound). Therefore musical work forms (e.g., music listening and singing) are used additionally.In the first phase of data collection stories of care professionals about the intertwining of their lifeline and career have been collected. In the second, listening phase HR-professionals listened to the stories told by the care professionals and used them as a source of inspiration for HR policy innovation.In a former article the methodology of the storytelling phase has been described. This article treats the methodology of the listening phase in the data collection. Later on the analysis methods will be described.

Health Care Professionals’ Knowledge Regarding Patient Safety

2016 ◽  
Vol 26 (3) ◽  
pp. 285-300 ◽  
Author(s):  
Indre Brasaite ◽  
Marja Kaunonen ◽  
Arvydas Martinkenas ◽  
Vida Mockiene ◽  
Tarja Suominen
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Continuing Education ◽  
Quantitative Study ◽  
Health Care Professionals ◽  
Pressure Sore ◽  
Knowledge Level ◽  
Background Factors ◽  
Low Level ◽  
Safety Knowledge

This study looks to describe health care professionals’ knowledge regarding patient safety. A quantitative study using questionnaires was conducted in three multi-disciplinary hospitals in Western Lithuania. Data were collected in 2014 from physicians, nurses, and nurse assistants. The overall results indicated quite a low level of safety knowledge, especially in regard to knowledge concerning general patient safety. The health care professionals’ background factors such as their profession, education, the information about patient safety they were given during their vocational and continuing education, as well as their experience in their primary speciality seemed to be associated with several patient safety knowledge areas. Despite a wide variation in background factors, the knowledge level of respondents was generally found to be low. This requires that further research into health care professionals’ safety knowledge related to specific issues such as medication, infection, falls, and pressure sore prevention should be undertaken in Lithuania.

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