Patient Safety and the Reliability of Health Care Systems

Children are particularly vulnerable to patient safety concerns due to pediatric-specific and general health care challenges. This scoping review identifies and describes the vulnerabilities of those aged 0 to 18 years to iatrogenic harm in various health care settings. Six databases were searched from 1991 to 2012. Primary studies were categorized using predetermined groupings. Categories were tallied and descriptive statistics were employed. A total of 388 primary studies exploring interventions that improved patient safety, deficiencies, or errors leading to safety concerns were included. The most common issues were medication (189 studies, 48.7%) and general medical (81 studies, 20.9%) errors. Sixty studies (15.5%) evaluated or described patient safety interventions, 206 studies (53.1%) addressed health care systems and technologies, 17 studies (4.4%) addressed caregiver perspectives and 20 studies (5.2%) discussed analytic models for patient safety. Further work is needed to ensure consistency of definitions in patient safety research to facilitate comparison and collation of results.

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Why Are Digital Health Care Systems Still Poorly Designed, and Why Is Health Care Practice Not Asking for More? Three Paths Toward a Sustainable Digital Work Environment

Journal of Medical Internet Research ◽

10.2196/26694 ◽

2021 ◽

Vol 23 (6) ◽

pp. e26694

Author(s):

Johanna Persson ◽

Christofer Rydenfält

Keyword(s):

Health Care ◽

Patient Safety ◽

Work Environment ◽

Digital Health ◽

Health Care Systems ◽

Digital Systems ◽

User Context ◽

Care Systems ◽

Digital Work ◽

And Task

Knowledge of how to design digital systems that are ergonomically sound, high in usability, and optimized for the user, context, and task has existed for some time. Despite this, there are still too many examples of new digital health care systems that are poorly designed and that could negatively affect both the work environment of health care staff and patient safety. This could be because of a gap between the theoretical knowledge of design and ergonomics and the practical implementation of this knowledge in procuring and developing digital health care systems. Furthermore, discussions of digitalization are often at a general level and risk neglecting the nature of direct interaction with the digital system. This is problematic since it is at this detailed level that work environment and patient safety issues materialize in practice. In this paper, we illustrate such issues with two scenarios concerned with contemporary electronic health care records, based on field studies in two health care settings. We argue that current methods and tools for designing and evaluating digital systems in health care must cater both to the holistic level and to the details of interaction and ergonomics. It must also be acknowledged that health care professionals are neither designers nor engineers, so expectations of them during the development of digital systems must be realistic. We suggest three paths toward a more sustainable digital work environment in health care: (1) better tools for evaluating the digital work environment in the field; (2) generic formulations of qualitative requirements related to usability and for adaptation to the user, context, and task, to be used in procurement; and (3) the introduction of digital ergonomics as an embracing concept capturing several of the ergonomic challenges (including physical, cognitive, and organizational aspects) involved in implementing and using digital systems.

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Impact of COVID-19 on Lung Transplant Activity in Germany—A Cross-Sectional Survey

The Thoracic and Cardiovascular Surgeon ◽

10.1055/s-0040-1715436 ◽

2020 ◽

Author(s):

Sebastian Michel ◽

Christian Witt ◽

Jens Gottlieb ◽

Clemens Aigner

Keyword(s):

Health Care ◽

Patient Safety ◽

Severe Acute Respiratory Syndrome ◽

Lung Transplant ◽

Health Care Systems ◽

Time Frame ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Variable Extent ◽

Care Systems

AbstractThe current COVID-19 pandemia affects health care systems worldwide, however, to a variable extent depending on the caseload in each country. We aimed to provide a cross-sectional overview of current limitations or adaptions in lung transplant programs in Germany in from January to May 2020 due to the COVID-19 pandemia caused by severe acute respiratory syndrome coronavirus 2. A cross-sectional survey assessing various aspects of lung transplant activity was sent to all active lung transplant programs (n = 12) in Germany. Eight centers (66%) responded to the survey within the requested time frame. Four centers (50%) reported their activity is not restricted at all and four centers (50%) reported on moderate general limitations. The overall lung transplant activity in Germany from January to May 2020 contains 128 bilateral and 11 single lung transplantations, which is similar to the same period in the year 2019 (126 bilateral transplantations and 12 single lung transplantations). The results suggest that the influence of the COVID-19 pandemia on lung transplantation activity in Germany has been moderate so far. Nevertheless, adaptions such as extensive testing of donors and recipients were introduced to reduce the likelihood of infections and increase patient safety. Alertness to changes in COVID-19 reproduction rates might be required until effective antiviral therapy or vaccination is available.

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Critical Incident Reporting System (CIRS): a fundamental component of risk management in health care systems to enhance patient safety

Safety in Health ◽

10.1186/s40886-017-0060-y ◽

2017 ◽

Vol 3 (1) ◽

Cited By ~ 3

Author(s):

Walter Petschnig ◽

Elisabeth Haslinger-Baumann

Keyword(s):

Health Care ◽

Patient Safety ◽

Critical Incident ◽

Reporting System ◽

Health Care Systems ◽

Critical Incident Reporting System ◽

Incident Reporting System ◽

Enhance Patient Safety ◽

Care Systems ◽

Critical Incident Reporting

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Why Are Digital Health Care Systems Still Poorly Designed, and Why Is Health Care Practice Not Asking for More? Three Paths Toward a Sustainable Digital Work Environment (Preprint)

10.2196/preprints.26694 ◽

2020 ◽

Author(s):

Johanna Persson ◽

Christofer Rydenfält

Keyword(s):

Health Care ◽

Patient Safety ◽

Work Environment ◽

Digital Health ◽

Health Care Systems ◽

Digital Systems ◽

User Context ◽

Care Systems ◽

Digital Work ◽

And Task

UNSTRUCTURED Knowledge of how to design digital systems that are ergonomically sound, high in usability, and optimized for the user, context, and task has existed for some time. Despite this, there are still too many examples of new digital health care systems that are poorly designed and that could negatively affect both the work environment of health care staff and patient safety. This could be because of a gap between the theoretical knowledge of design and ergonomics and the practical implementation of this knowledge in procuring and developing digital health care systems. Furthermore, discussions of digitalization are often at a general level and risk neglecting the nature of direct interaction with the digital system. This is problematic since it is at this detailed level that work environment and patient safety issues materialize in practice. In this paper, we illustrate such issues with two scenarios concerned with contemporary electronic health care records, based on field studies in two health care settings. We argue that current methods and tools for designing and evaluating digital systems in health care must cater both to the holistic level and to the details of interaction and ergonomics. It must also be acknowledged that health care professionals are neither designers nor engineers, so expectations of them during the development of digital systems must be realistic. We suggest three paths toward a more sustainable digital work environment in health care: (1) better tools for evaluating the digital work environment in the field; (2) generic formulations of qualitative requirements related to usability and for adaptation to the user, context, and task, to be used in procurement; and (3) the introduction of digital ergonomics as an embracing concept capturing several of the ergonomic challenges (including physical, cognitive, and organizational aspects) involved in implementing and using digital systems.

Download Full-text