Patient Safety in Surgical Care

2016 ◽  
Author(s):  
Caprice C. Greenberg ◽  
Amir Ghaferi
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Systems Engineering ◽  
Health Care Professionals ◽  
Care Facility ◽  
Surgical Care ◽  
The United States ◽  
Adverse Outcomes ◽  
Patient Safety Indicators ◽  
National Quality

The 1999 report of the Institute of Medicine, To Err Is Human: Building a Safer Health System, made national headlines with its estimates of the frequency and severity of adverse events in health care, including that as many as 98,000 medical error–related deaths occur each year in the United States. The observation that the basic principles of human error are highly applicable to clinical practice has markedly advanced our understanding and willingness to address error in this setting. This review seeks to address the characteristics of systems in general and the system of surgical care in particular. It describes the growing knowledge of factors that affect human performance and how these factors contribute to adverse surgical outcomes. The review also outlines current obstacles to improving safety,  identifies  systems approaches to making improvements, and discusses ways in which surgeons can take the lead in overcoming these obstacles. An overall goal is that acceptance of error and a willingness to investigate its underlying causes will allow health care professionals to make use of the lessons learned from study of nonmedical systems. Tables include definitions of terms related to patient safety, the operation profile, handoff coordination and communication objectives and relevant strategies, nonmedical system techniques applicable to medical systems, Agency for Healthcare Quality and Research patient safety indicators, National Quality Forum list of health care facility–related serious reportable events, and examples of surgically relevant quality improvement practices appropriate for widespread implementation. Figures include the Swiss Cheese Model representing the relationship between latent and active errors and adverse outcomes, a schematic depiction of the process by which system failures may lead to injury, the Systems Engineering in Patient Safety Model of work system and patient safety, and a depiction of contrasting characteristics of medical practice in the 20th and 21st centuries.This review contains 4 figures, 7 tables, and 165 references.

Patient Safety in Surgical Care

2014 ◽  
Author(s):  
Caprice C. Greenberg ◽  
Amir Ghaferi
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Systems Engineering ◽  
Health Care Professionals ◽  
Care Facility ◽  
Surgical Care ◽  
The United States ◽  
Adverse Outcomes ◽  
Patient Safety Indicators ◽  
National Quality

The 1999 report of the Institute of Medicine, To Err Is Human: Building a Safer Health System, made national headlines with its estimates of the frequency and severity of adverse events in health care, including that as many as 98,000 medical error–related deaths occur each year in the United States. The observation that the basic principles of human error are highly applicable to clinical practice has markedly advanced our understanding and willingness to address error in this setting. This review seeks to address the characteristics of systems in general and the system of surgical care in particular. It describes the growing knowledge of factors that affect human performance and how these factors contribute to adverse surgical outcomes. The review also outlines current obstacles to improving safety,  identifies  systems approaches to making improvements, and discusses ways in which surgeons can take the lead in overcoming these obstacles. An overall goal is that acceptance of error and a willingness to investigate its underlying causes will allow health care professionals to make use of the lessons learned from study of nonmedical systems. Tables include definitions of terms related to patient safety, the operation profile, handoff coordination and communication objectives and relevant strategies, nonmedical system techniques applicable to medical systems, Agency for Healthcare Quality and Research patient safety indicators, National Quality Forum list of health care facility–related serious reportable events, and examples of surgically relevant quality improvement practices appropriate for widespread implementation. Figures include the Swiss Cheese Model representing the relationship between latent and active errors and adverse outcomes, a schematic depiction of the process by which system failures may lead to injury, the Systems Engineering in Patient Safety Model of work system and patient safety, and a depiction of contrasting characteristics of medical practice in the 20th and 21st centuries. This review contains 4 figures, 7 tables, and 165 references.

Patient Safety in Surgical Care

2017 ◽  
Author(s):  
Caprice C. Greenberg ◽  
Amir Ghaferi
Keyword(s):  
Health Care ◽  
Patient Safety ◽  
Systems Engineering ◽  
Health Care Professionals ◽  
Care Facility ◽  
Surgical Care ◽  
The United States ◽  
Adverse Outcomes ◽  
Patient Safety Indicators ◽  
National Quality

The 1999 report of the Institute of Medicine, To Err Is Human: Building a Safer Health System, made national headlines with its estimates of the frequency and severity of adverse events in health care, including that as many as 98,000 medical error–related deaths occur each year in the United States. The observation that the basic principles of human error are highly applicable to clinical practice has markedly advanced our understanding and willingness to address error in this setting. This review seeks to address the characteristics of systems in general and the system of surgical care in particular. It describes the growing knowledge of factors that affect human performance and how these factors contribute to adverse surgical outcomes. The review also outlines current obstacles to improving safety,  identifies  systems approaches to making improvements, and discusses ways in which surgeons can take the lead in overcoming these obstacles. An overall goal is that acceptance of error and a willingness to investigate its underlying causes will allow health care professionals to make use of the lessons learned from study of nonmedical systems. Tables include definitions of terms related to patient safety, the operation profile, handoff coordination and communication objectives and relevant strategies, nonmedical system techniques applicable to medical systems, Agency for Healthcare Quality and Research patient safety indicators, National Quality Forum list of health care facility–related serious reportable events, and examples of surgically relevant quality improvement practices appropriate for widespread implementation. Figures include the Swiss Cheese Model representing the relationship between latent and active errors and adverse outcomes, a schematic depiction of the process by which system failures may lead to injury, the Systems Engineering in Patient Safety Model of work system and patient safety, and a depiction of contrasting characteristics of medical practice in the 20th and 21st centuries. This review contains 4 figures, 7 tables, and 165 references.

scholarly journals Burnout Impact of COVID-19 Pandemic on Health-Care Professionals at Assiut University Hospitals, 2020

2021 ◽  
Vol 18 (10) ◽  
pp. 5368
Author(s):  
Shimaa A. Elghazally ◽  
Atef F. Alkarn ◽  
Hussein Elkhayat ◽  
Ahmed K. Ibrahim ◽  
Mariam Roshdy Elkhayat
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Emotional Exhaustion ◽  
Health Care Professionals ◽  
Maslach Burnout Inventory ◽  
Adverse Outcomes ◽  
Personal Accomplishment ◽  
Burnout Syndrome ◽  
Care Providers ◽  
University Hospitals

Background: burnout syndrome is a serious and growing problem among medical staff. Its adverse outcomes not only affect health-care providers’ health, but also extend to their patients, resulting in bad-quality care. The COVID-19 pandemic puts frontline health-care providers at greater risk of psychological stress and burnout syndrome. Objectives: this study aimed to identify the levels of burnout among health-care professionals currently working at Assiut University hospitals during the COVID-19 pandemic. Methods: the current study adopted an online cross-sectional design using the SurveyMonkey® website for data collection. A total of 201 physicians were included and the Maslach Burnout Inventory (MBI) scale was used to assess the three burnout syndrome dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment. Results: about one-third, two-thirds, and one-quarter of the respondents had high emotional exhaustion, high depersonalization, and low personal accomplishment, respectively. Younger, resident, and single physicians reported higher burnout scores. The personal accomplishment score was significantly higher among males. Those working more than eight hours/day and dealing with COVID-19 patients had significantly higher scores. Conclusion: during the COVID-19 pandemic, a high prevalence of burnout was recorded among physicians. Age, job title, working duration, and working hours/day were significant predictors for burnout syndrome subscale results. Preventive and interventive programs should be applied in health-care organizations during pandemics.

scholarly journals PARE0017 THE DREAMCATCHER – AN INNOVATIVE TOOL FOCUSING ON POSSIBILITIES INSTEAD OF LIMITATIONS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1294.1-1294
Author(s):  
C. Helin Hollstrand ◽  
K. Nilke Nordlund
Keyword(s):  
Health Care ◽  
Young Adults ◽  
Rheumatic Disease ◽  
Health Care Professionals ◽  
Behavioral Science ◽  
Resource Planning ◽  
Pain Scale ◽  
Digital Tool ◽  
Starting Point ◽  
National Quality

Background:With the launch of The Swedish Young Rheumatics Report in April of 2018, we also presented new way of thinking and a tool called the Dreamscale, our complement to the traditional VAS scale used to assess pain. In October of 2018, we organized a workshop together with communication consults where we invited some of our members in different ages and health care professionals working with children, youths and young adults with rheumatic diseases, to try and reach a joint definition of what the Dreamscale is and could be, as we saw its huge potential. This is where the idea of the Dreamcatcher was born.Objectives:The objective is to create an innovative digital tool for young people with rheumatic disease. It takes its starting point in what is healthy and what is possible, rather than focusing on sickness and limitations. Using behavioral science, nudging and social functions, the Dreamcatcher has the potential to lower the barriers to living an active lifestyle, while also serving as a tool for dialogue with health care professionals, resulting in more efficient meetings, better resource planning and the gathering of valuable data to the national quality registers. It is also a digital tool with a big potential for development thanks to its open source code and its focus on enabling activity and participation, there is an obvious potential to develop its functions to also serve other actors and patient groups.Methods:We teamed up with communication bureau Gullers Grupp, pharmaceutical company Pfizer, and two health care clinics in Stockholm, one for children and youths with rheumatic disease and one for adults, and received funding for one year of development from Vinnova, the Swedish innovation authority, in April of 2019. We started the project by conducting a study to try and narrow down what focuses the Dreamcatcher should have. The pilot study contains both workshops with patients, both children, youths and young adults, and with teams of health care professionals, as well as more in-depth interviews with both patients and health care professionals. Based on the study, we will develop a prototype of what the Dreamcatcher could look like, and it will most likely be an application used for smartphones.Results:The study narrows down the Dreamcatcher into three things: the Dreamscale, Dream data, and the Dream collective.The Dreamscaleis as previously explained a complement to the traditional pain-scale and a tool for patients to set goals towards their dreams, and for patients and health care professionals to co-plan care and medical treatment based on what’s most important to the patient.Dream datais where patients can self-track their disease, data which is also available for the health care to view and therefore to be better prepared before meeting with the patient. It is also a goal to have the Dream data transferred to the national quality registers.The Dream collectiveis a social function where patients using the app can connect and get inspired by each other. It is a place to share your dreams and build a community to show that rheumatic disease isn’t something that should ever stop you from going after your dreams!Conclusion:The prototype of the Dreamcatcher will be presented in May of 2020 and we think this it has great potential to help shift focus withing health care, to not just focusing on sickness and limitations but rather on dreams, joy of life and possibilities!References:[1]https://ungareumatiker.se/nytt-digitalt-patientverktyg-unga-reumatiker-tar-fram-dromfangaren/[2]https://www.youtube.com/watch?v=zD6PwSKeb8IDisclosure of Interests:None declared

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.

INTRODUCTION

PEDIATRICS ◽  
1993 ◽  
Vol 91 (5) ◽  
pp. ii-ii
Keyword(s):  
Health Care ◽  
Chronic Illness ◽  
Child Development ◽  
Health Services ◽  
Cultural Sensitivity ◽  
Health Care Professionals ◽  
Research Policy ◽  
The United States ◽  
Policy Formulation ◽  
Full Account

In June 1992, 35 health care professionals, child and disability advocates, researchers, clinicians, and parents met at Wingspread Center in Racine, Wisconsin, for an invitational conference on Culture and Chronic Illness in Childhood. The meeting had as its goal the identification of the state of knowledge on the interface between culture, chronic illness, child development, and family functioning so as to lay the foundations for "culturally appropriate" health policy formulation, "culturally sensitive" services, and "culturally competent" clinicians. The purpose of this special supplement is to establish a national agenda for research, policy, service delivery, and training in addressing the needs of all children with chronic illnesses and disabilities that takes the family, ethnicity, socioeconomic status, and culture into full account. To meet this task, five papers were commissioned. The first, by Newacheck et al, addresses the changes in incidence and prevalence of chronic illness and disability among children and youth by ethnic group. The second paper, by McManus et al, focuses on the trends in health services organization, delivery, and financing as they vary among ethnic groups in the United States. What emerges is a rhetoric of cultural sensitivity not paralleled in the organization or financing of health services. Groce and Zola's paper addresses how cultural attitudes and beliefs are the foundations of our perceptions about health and illness. Those perceptions at times are predisposed to conflict with a health care professional who, coming from a different culture, may hold different norms and beliefs. Brookins grounds her discussion within the context of child development and argues that for a child of color or one whose ethnic heritage is other than mainstream, the key to developmental success is bicultural competence—the ability to walk in and between two worlds.

scholarly journals Safeguarding Abuse in Health Care

2018 ◽  
Vol 12 (2) ◽  
pp. 5-10
Author(s):  
Chanda Karki Bhandari ◽  
Gehanath Baral
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Care Facility ◽  
Health Care Facility ◽  
Healthcare Facility ◽  
Structural Level ◽  
Care Providers ◽  
Ethical Guidelines ◽  
Abuse In Health Care

Aims: The aim of the review is to understand the concept of abuse in health care in general and its various forms. It includes- review what is meant by healthcare and health care abuse; identify its various forms and to recognize who may be the most potential victims; find out the reasons of abuse by health care providers; and know the role of  ethical guidelines and institutional policy in confronting abuse in health care.Methods: Literatures and publications on the subject were searched in order to identify research studies investigating abuse in health care that were studied, analyzed and presented.  Results: Abuse in health care today is an emerging concept in need of a clear analysis and definition. At the same time, boundaries to the related concepts are not demarcated. Medical professionals and institutions are being targeted worldwide today for negligence and the medical litigation has become a huge challenge. Throughout history, health care professionals have been trusted because of their competency and caring abilities. However, the disturbing reality is that physical and psychological maltreatment of patients do occur in the health care settings throughout the world. The abuse can vary from treating someone with disrespect in a way which significantly affects the person's quality of life, to causing actual physical suffering. Differently able and dependent people are more susceptible to such abuse. Work overload, Staff burnout, lack of information and instructions were also indicated to underlie instances of abuse in health care.Conclusions: We in the healthcare facility should first accept that abuse in health care does occur and causes distress. This change needs to occur at individual, cultural and structural level. Next step will be for the staffs to be aware of abuse in health care when it happens and recognize it as such. It is always better to create a situation where we could prevent abuse from happening at health centers. Hospital personnel must implement a change in workplace culture to stop abusive behaviors wherever they occur. Each and every health care facility should be client friendly and respecting their rights. Effective ethical guidelines were needed to minimize abuse as existing ethical codes were found to be ineffective and above all there was a lack of awareness of the contents of the relevant ethical documents.

Implementation of Wireless “Intelligent” Pump IV Infusion Technology in a Not-for-Profit Academic Hospital Setting

2007 ◽  
Vol 42 (9) ◽  
pp. 832-840 ◽  
Author(s):  
Lor Siv-Lee ◽  
Linda Morgan
Keyword(s):  
Health Care ◽  
Health Care Professionals ◽  
Hospital Setting ◽  
The United States ◽  
Main Campus ◽  
For Profit ◽  
Not For Profit ◽  
Drug Concentrations ◽  
Wireless Infrastructure ◽  
Infusion System

Purpose This paper describes the implementation of wireless “intelligent” pump intravenous (IV) infusion technology in a not-for-profit academic, multicampus hospital system in the United States. Methods The process of implementing a novel infusion system in a multicampus health care institution (main campus plus three satellite campuses) is described. Details are provided regarding the timelines involved, the process for the development of the drug libraries, and the initial implementation within and across campuses. Results In early 2004, with the end of the device purchase contract period nearing, a multidisciplinary committee evaluated potential IV infusion pumps for hospital use. In April 2004, the committee selected the Plum A+ infusion system with Hospira MedNet software and wireless capabilities (Hospira Inc., Lake Forest, IL). Implementation of the single-channel IV infusion system took place July through October 2005 following installation of the wireless infrastructure throughout the multicampus facility. Implementation occurred in July, one campus at a time; the three smaller satellite campuses went “live” before the main campus. Implementation of the triple-channel IV infusion system took place in March 2006 when the wireless infrastructure was completed and fully functional throughout the campuses, software was upgraded, and drug library revisions were completed and uploaded. Conclusion “Intelligent” pump technology provided a framework to standardize drug concentrations used in the intensive care units. Implementation occurred transparently without any compromise of patient care. Many lessons were learned during implementation that explained the initial suboptimal compliance with safety software use. In response, the committee developed strategies to increase software utilization rates, which resulted in improved acceptance by nursing staff and steadily improving compliance rates. Wireless technology has supported remote device management, prospective monitoring, the avoidance of medication error, and the timely education of health care professionals regarding potential medication errors.

scholarly journals Non-health Care Facility Medication Errors Associated with Hormones and Hormone Antagonists in the United States

2017 ◽  
Vol 13 (4) ◽  
pp. 293-302
Author(s):  
Pranav Magal ◽  
Henry A. Spiller ◽  
Marcel J. Casavant ◽  
Thitphalak Chounthirath ◽  
Nichole L. Hodges ◽  
...  
Keyword(s):  
United States ◽  
Health Care ◽  
Medication Errors ◽  
Care Facility ◽  
Health Care Facility ◽  
The United States ◽  
Hormone Antagonists
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