Simulation in Medicine: Addressing Patient Safety and Improving the Interface Between Healthcare Providers and Medical Technology

2006 ◽  
Vol 40 (5) ◽  
pp. 399-404 ◽  
Author(s):  
Elizabeth A. Hunt ◽  
Kristen L. Nelson ◽  
Nicole A. Shilkofski
Keyword(s):  
Patient Safety ◽  
Medical Technology ◽  
Healthcare Providers ◽  
Hospital Setting ◽  
Medical Simulation ◽  
Human Factors Engineering ◽  
Safe Environment ◽  
Enhance Patient Safety ◽  
History Of ◽  
And Performance

Abstract Medicine, as an industry in which human lives depend on the skill and performance of operators, must create and maintain a culture of safety, in addition to promoting the design of systems to mitigate errors. The use of medical simulation as a mechanism for training healthcare professionals in a safe environment is expanding rapidly. An important component of systems that ensure the safety of patients in the hospital setting is the interface between humans and technology in the hospital. The objective of this paper is to review: (1) the definition and a brief history of medical simulation, (2) examples of how current medical simulation centers are using simulation to address patient safety, and (3) examples of how simulation can be used to enhance patient safety through improvement of the interface between healthcare practitioners and medical technology. Medical simulation and human factors engineering can be used to examine and enhance the interface between health-care practitioners and medical technology, with the potential to make a significant contribution to patient safety.

scholarly journals Malpractice Claimed Calls within the Swedish Healthcare Direct: A Descriptive – Comparative Case Study

2020 ◽  
Author(s):  
Annica Bjorkman ◽  
Maria Engström ◽  
Ulrika Winblad ◽  
Inger K Holmström
Keyword(s):  
Patient Safety ◽  
Medical Errors ◽  
Work Groups ◽  
Healthcare Providers ◽  
Total Sample ◽  
Comparative Case Study ◽  
Healthcare Organizations ◽  
Computerized Decision Support ◽  
Malpractice Claims ◽  
Enhance Patient Safety

Abstract Background: Medical errors are reported as a malpractice claim, and it is of uttermost importance to learn from the errors to enhance patient safety. The Swedish national telephone helpline SHD is staffed by registered nurses; its aim is to provide qualified healthcare advice for all residents of Sweden; it handles about 5 million calls annually. The aim of the present study was twofold: to describe all malpractice claims and healthcare providers’ reported measures regarding calls to Swedish Healthcare Direct (SHD) during the period January 2011-December 2018 and to compare these findings with results from a previous study covering the period 2003-2010.Methods: The study used a descriptive and comparative design. A total sample of all reported malpractice claims regarding calls to SHD (n=35) made during the period 2011-2018 was retrieved. Data were analysed and compared with all reported medical errors during the period 2003-2010 (n=33). Results: Telephone nurses’ failure to follow the computerized decision support system (CDSS) (n=18) was identified as the main reason for error during the period 2011-2018, while failure to listen to the caller (n=12) was the main reason during the period 2003-2010. Staff education (n=21) and listening to one’s own calls (n=16) were the most common measures taken within the organization during the period 2011-2018, compared to discussion in work groups (n=13) during the period 2003-2010.Conclusion: The proportion of malpractice claims in relation to all patient contacts to SHD is still very low; it seems that only the most severe patient injuries are reported. The fact that telephone nurses’ failure to follow the CDSS is the most common reason for error is notable, as SHD and healthcare organizations stress the importance of using the CDSS to enhance patient safety. The healthcare organizations seem to have adopted a more systematic approach to handling malpractice claims regarding calls, e.g., allowing telephone nurses to listen to their own calls instead of having discussions in work groups in response to events. This enables nurses to understand the latent factors contributing to error and provides a learning opportunity.

scholarly journals Process Failures That Increase the Risk of Infection Through Respiratory Droplets: A Study of Patient Safety Events Reported by Hospitals Across Pennsylvania

2020 ◽  
pp. 10-23
Author(s):  
Amy Harper ◽  
Elizabeth Kukielka ◽  
Rebecca Jones
Keyword(s):  
Patient Safety ◽  
Respiratory Infections ◽  
Hospital Setting ◽  
Standard Of Care ◽  
Rapid Identification ◽  
Respiratory Pathogens ◽  
Infectious Agents ◽  
Enhance Patient Safety ◽  
Respiratory Droplets ◽  
Process Failures

Respiratory pathogens can lead to pneumonia, bronchiolitis, and death. Rapid identification, along with appropriate standard and isolation precautions, are necessary to prevent the spread of infectious agents causing respiratory infections. We analyzed patient safety events reported to the Pennsylvania Patient Safety Reporting System that were related to viruses and bacteria spread through respiratory droplets. An analysis of events that occurred from January 1, 2019, through December 31, 2019, led to the identification of 338 events involving process failures related to recognizing infectious agents that are spread through respiratory droplets, implementing measures to prevent their spread, or providing timely treatment. Detailed analysis of the process failures showed that 54.9% were associated with processes in testing or processing of laboratory specimens; 29.7% were associated with isolation-related procedures; and 15.4% were associated with medications, triage/assessment, documentation/verbal communication, or not providing the standard of care for patients in missed/delayed orders, procedures, or referrals. Implementation of risk-reduction strategies can help to further reduce the spread of pathogens through respiratory droplets in the hospital setting and further enhance patient safety. These strategies include evaluating collection processes for testing/laboratory specimens, consistently using empiric isolation precautions based on initial triage and patient presentation, and evaluating processes for admissions and transfers.

scholarly journals Breach of confidentiality: unintentional common practice due to misunderstanding and unawareness

2012 ◽  
Vol 2 (3) ◽  
pp. 16-18
Author(s):  
Mohammad Waseem Khan
Keyword(s):  
Medical Technology ◽  
Ethical Issues ◽  
Hospital Setting ◽  
The Other ◽  
Privileged Information ◽  
Confidential Information ◽  
Public Places ◽  
Other Hand ◽  
Public Areas ◽  
History Of

Advancement in medical technology has helped man kind in several ways and no one can deny the contribution of medical technology in the field of medicine. On the other hand technology has also given rise to some ethical issues. The issue of confidentiality is one of those issues. Patients keeping their trust on physician reveals all concerned confidential information to their physician with surety that physician will not reveal it to other person and will keep it confidential. It has been common in practice that, physicians unintentionally breach their patient’s confidentiality by discussing cases and history of their patients in public places, hospital elevators, and with their students. In a busy hospital setting it can be difficult to maintain confidentiality for patients. Increasing workloads lead to discussions of patients in public areas which is not an acceptable excuse. The very next person present there listening the discussion could be a patient's friend, relative, or media member that is not entitled to this privileged information. In all these cases permission must be received from the patient prior to any disclosure.DOI: http://dx.doi.org/10.3329/bioethics.v2i3.10259Bangladesh Journal of Bioethics 2011;2(3):16-18

scholarly journals Standardized Handoffs After Pediatric Residency: Retention of Practices and Perceived Importance

2021 ◽  
Vol 5 (2) ◽  
pp. 26
Author(s):  
Eva Seligman ◽  
Thuy Ngo
Keyword(s):  
Patient Safety ◽  
Medical Errors ◽  
Hospital Setting ◽  
Descriptive Statistics ◽  
Advanced Practice ◽  
Practice Setting ◽  
Electronic Survey ◽  
Pediatric Residency ◽  
Perceived Importance ◽  
Enhance Patient Safety

The I-PASS Handoff Program is linked to reduced medical errors. The enduring handoff practices of residency graduates trained in I-PASS, and attitudes thereof, are unknown. Our objective was to investigate how often residency graduates use I-PASS or other handoff tools, and perspectives regarding standardized handoffs beyond residency. We performed an exploratory electronic survey of residency graduates from programs who participated in the original I-PASS study. Responses were analyzed using descriptive statistics. Of the 106 respondents, 64/106 (60%) identified as “attendings” and the remainder of respondents were subspeciality fellows. The most common practice setting was the inpatient hospital setting, 42/106 (39%). Regarding handoff use, 61/106 (58%) “rarely” or “never” used standardized handoffs. Of those using handoffs, 13/76 (17%) used I-PASS and 59/76 (78%) used a personal system. Most (95/101, 94%) were unaware of any dedicated handoff training or reported it did not exist for attendings, although 77/106 (73%) endorsed their importance for attendings. Despite rigorous residency training and belief in its importance, over one third of graduates did not use standardized handoffs. System-wide requirements for standardized handoffs may improve communication among all providers including physicians, advanced practice providers, and nurses, and enhance patient safety.

scholarly journals LO66: Strengthening team communication may decrease medico-legal risk for physicians in the emergency department

CJEM ◽  
2020 ◽  
Vol 22 (S1) ◽  
pp. S31-S32
Author(s):  
A. MacIntyre ◽  
Q. Yang ◽  
R. De Gorter ◽  
S. Lee ◽  
L. Calder
Keyword(s):  
Emergency Department ◽  
Patient Safety ◽  
Descriptive Analysis ◽  
Healthcare Providers ◽  
Team Communication ◽  
Legal Cases ◽  
Team Members ◽  
Legal Risk ◽  
For Profit ◽  
Enhance Patient Safety

Introduction: In a busy emergency department (ED), effective communication is integral to the provision of safe medical care. Physicians working in the ED interact with multiple team members including patients, allied healthcare professionals and other physicians, who all need to understand their verbal and written instructions. Our study's objective was to identify and describe communication problems occurring in the ED setting, and how these problems contributed to patient safety events and increased medico-legal risk for physicians. Methods: The Canadian Medical Protective Association (CMPA) is a not-for-profit, medico-legal organization which represented over 97,000 physicians at the time of this study. We conducted a retrospective descriptive analysis where we extracted five years (2013-2017) of CMPA data describing closed medico-legal cases occurring in the ED involving physicians (any specialty) who experienced complaints due to communication issues. We then applied an internal contributing factor framework to identify data themes. Data were summarized using descriptive statistics. Results: We identified 517 eligible cases involving 521 patients (some cases involved >1 patient). We found that 99.8% (520/521) of patients experienced some form of healthcare-related harm in the ED. Specifically, there was poor communication between: the physician and patient or patient's family (202/517, 39.1%); two or more physicians (79/517, 15.3%), and physicians and other healthcare providers (55/517, 10.6%). Inadequate documentation was observed in more than half of the cases (324/517, 62.7%) and poor team communication affected physicians’ decision making process (326/517, 63%) in areas such as deficient assessments, inadequate investigations, failure or delay to attend to the patient, and disposition decisions. Conclusion: Team communication issues are prevalent among physician medico-legal cases occurring in the ED. Efforts to strengthen communication skills may enhance patient safety and reduce medico-legal risk.

scholarly journals Malpractice claimed calls within the Swedish Healthcare Direct: a descriptive – comparative case study

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Annica Björkman ◽  
Maria Engström ◽  
Ulrika Winblad ◽  
Inger K. Holmström
Keyword(s):  
Patient Safety ◽  
Medical Errors ◽  
Work Groups ◽  
Healthcare Providers ◽  
Total Sample ◽  
Comparative Case Study ◽  
Healthcare Organizations ◽  
Computerized Decision Support ◽  
Malpractice Claims ◽  
Enhance Patient Safety

Abstract Background Medical errors are reported as a malpractice claim, and it is of uttermost importance to learn from the errors to enhance patient safety. The Swedish national telephone helpline SHD is staffed by registered nurses; its aim is to provide qualified healthcare advice for all residents of Sweden; it handles normally about 5 million calls annually. The ongoing Covid-19 pandemic have increased call volume with approximate 30%. The aim of the present study was twofold: to describe all malpractice claims and healthcare providers’ reported measures regarding calls to Swedish Healthcare Direct (SHD) during the period January 2011–December 2018 and to compare these findings with results from a previous study covering the period January 2003–December 2010. Methods The study used a descriptive, retrospective and comparative design. A total sample of all reported malpractice claims regarding calls to SHD (n = 35) made during the period 2011–2018 was retrieved. Data were analysed and compared with all reported medical errors during the period 2003–2010 (n = 33). Results Telephone nurses’ failure to follow the computerized decision support system (CDSS) (n = 18) was identified as the main reason for error during the period 2011–2018, while failure to listen to the caller (n = 12) was the main reason during the period 2003–2010. Staff education (n = 21) and listening to one’s own calls (n = 16) were the most common measures taken within the organization during the period 2011–2018, compared to discussion in work groups (n = 13) during the period 2003–2010. Conclusion The proportion of malpractice claims in relation to all patient contacts to SHD is still very low; it seems that only the most severe patient injuries are reported. The fact that telephone nurses’ failure to follow the CDSS is the most common reason for error is notable, as SHD and healthcare organizations stress the importance of using the CDSS to enhance patient safety. The healthcare organizations seem to have adopted a more systematic approach to handling malpractice claims regarding calls, e.g., allowing telephone nurses to listen to their own calls instead of having discussions in work groups in response to events. This enables nurses to understand the latent factors contributing to error and provides a learning opportunity.

Sea Urchins and Circuses: The Modernist Natural Histories of Jean Painlevé and Alexander Calder

2018 ◽  
Vol 13 (2) ◽  
pp. 187-211
Author(s):  
Patricia E. Chu
Keyword(s):  
New Media ◽  
Sea Urchins ◽  
Life Sciences ◽  
Three Dimensional ◽  
Machine Age ◽  
Avant Garde ◽  
History Of ◽  
And Performance ◽  
The One ◽  
Natural Historian

The Paris avant-garde milieu from which both Cirque Calder/Calder's Circus and Painlevé’s early films emerged was a cultural intersection of art and the twentieth-century life sciences. In turning to the style of current scientific journals, the Paris surrealists can be understood as engaging the (life) sciences not simply as a provider of normative categories of materiality to be dismissed, but as a companion in apprehending the “reality” of a world beneath the surface just as real as the one visible to the naked eye. I will focus in this essay on two modernist practices in new media in the context of the history of the life sciences: Jean Painlevé’s (1902–1989) science films and Alexander Calder's (1898–1976) work in three-dimensional moving art and performance—the Circus. In analyzing Painlevé’s work, I discuss it as exemplary of a moment when life sciences and avant-garde technical methods and philosophies created each other rather than being classified as separate categories of epistemological work. In moving from Painlevé’s films to Alexander Calder's Circus, Painlevé’s cinematography remains at the forefront; I use his film of one of Calder's performances of the Circus, a collaboration the men had taken two decades to complete. Painlevé’s depiction allows us to see the elements of Calder's work that mark it as akin to Painlevé’s own interest in a modern experimental organicism as central to the so-called machine-age. Calder's work can be understood as similarly developing an avant-garde practice along the line between the bestiary of the natural historian and the bestiary of the modern life scientist.

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