scholarly journals Using systems thinking in patient safety: a case study on medicines management

2017 ◽  
Vol 24 (4) ◽  
pp. 28-33 ◽  
Author(s):  
Mandy Brimble ◽  
Aled Jones
Author(s):  
Graham Brack ◽  
Penny Franklin ◽  
Jill Caldwell

Medicines Management for Nursing Practice: Pharmacology, Patient Safety, and Procedures is a friendly guide designed to equip pre-registration and newly qualified nurses with the medicines management knowledge and skills to provide safe patient-centred care. Balancing theory with practical advice, this accessible text covers basic pharmacology, drug calculations, key legislation and standards, and patient safety. Drawing from the most up-to-date sources of evidence and advice, including NMC and BNF guidelines, Medicines Management for Nursing Practice prepares nurses to promote their patients' safety, concordance, understanding of medicines, and wellbeing. This book takes a lively and straightforward approach to a vital set of nursing skills. Learning features such as reflection points, exercises, and further reading help readers to develop and consolidate their knowledge. Chapters on pharmacology and drug calculations take a step-by-step approach and are supported by diagrams and examples to aid understanding. Case studies relate guidelines and theories to the common practical scenarios that nurses encounter on a day-to-day basis.


2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Cassiana Gil Prates ◽  
Rita Catalina Aquino Caregnato ◽  
Ana Maria Müller de Magalhães ◽  
Daiane Dal Pai ◽  
Janete de Souza Urbanetto ◽  
...  

PurposeThe purpose is to assess the patient safety culture perceived by healthcare and administrative staff in a Brazilian hospital and examine whether education and experience are related to positive perceptions.Design/methodology/approachA descriptive–analytical case study was carried out at Ernesto Dornelles Hospital, a private Brazilian institution. The Brazilian version of the Hospital Survey on Patient Safety Culture was used to assess the perceptions of 618 participants, of whom 315 worked in healthcare assistance and 303 in administrative services. The main outcome was the percentage of positive responses, and the independent variables included the type of work, schooling and length of experience.FindingsNone of the twelve dimensions was strengthened. The percentage of positive responses was the highest for “Hospital management support for patient safety” (67.5%), and the lowest was for “Nonpunitive response to error” (29%). The healthcare staff had a slightly higher average than the administrative staff. The percentage of positive responses from professionals with undergraduate or graduate degrees was higher for the eight dimensions of safety culture. The length of hospital experience was not associated with any dimensions.Originality/valueThis study explored the influence of education and professional experience on the perception of patient safety in healthcare and administrative staff from a private institution. These approaches allow to know with greater depth and clarity factors that are related to the patient safety culture and, thus, have more consistent evidence to support interventions in specific needs.


2018 ◽  
Vol 19 (4) ◽  
pp. 327-342 ◽  
Author(s):  
Ruchi Agarwal ◽  
Sanjay Kallapur

PurposeThe purpose of this study is to explore the best practices for improving risk culture and defining the role of actors in risk governance.Design/methodology/approachThis paper presents an exemplar case of a British insurance company by using a qualitative case research approach.FindingsThe case study shows how the company was successful in changing from a compliance-based and defensive risk culture to a cognitive risk culture by using a systems thinking approach. Cognitive risk culture ensures that everybody understands risks and their own roles in risk governance. The change was accomplished by adding an operational layer between the first and second lines of defense and developing tools to better communicate risks throughout the organization.Practical implicationsPractitioners can potentially improve risk governance by using the company’s approach. The UK regulator’s initiative to improve risk culture can potentially be followed by other regulators.Originality/valueThis is among the few studies that describe actual examples of how a company can improve risk culture using the systems approach and how systems thinking simultaneously resolves several other issues such as poor risk reporting and lack of clarity in roles and responsibilities.


Author(s):  
Maggie Ollove ◽  
Diala Lteif

This paper explores the role of design in conflict resolution when doing so means balancing burdened pasts with present uncertainties. To prove its relevance in today’s complex problem spaces, design cannot remain stagnant; it must evolve alongside the pace of development. Designing within complexity is unprecedented. Yet, design can define structures that guide an understanding of this complexity. The methodology and case study described in this paper explore how systems thinking, storytelling and grounded theory can contribute to this understanding. The methodology aims to combine subjective perspectives with systemic analyses to create a collective narrative that reveals the multitude of individual understandings of conflicts. Ultimately, this methodology does not attempt to resolve conflict; instead, it  aims to provide an in-depth diagnosis of a wicked problem and question the role of design therein.


Author(s):  
Alex Ryan ◽  
Mark Leung

This paper introduces two novel applications of systemic design to facilitate a comparison of alternative methodologies that integrate systems thinking and design. In the first case study, systemic design helped the Procurement Department at the University of Toronto re-envision how public policy is implemented and how value is created in the broader university purchasing ecosystem. This resulted in an estimated $1.5 million in savings in the first year, and a rise in user retention rates from 40% to 99%. In the second case study, systemic design helped the clean energy and natural resources group within the Government of Alberta to design a more efficient and effective resource management system and shift the way that natural resource departments work together. This resulted in the formation of a standing systemic design team and contributed to the creation of an integrated resource management system. A comparative analysis of the two projects identifies a shared set of core principles for systemic design as well as areas of differentiation that reveal potential for learning across methodologies. Together, these case studies demonstrate the complementarity of systems thinking and design thinking, and show how they may be integrated to guide positive change within complex sociotechnical systems.


2020 ◽  
Author(s):  
J Wailling ◽  
Brian Robinson ◽  
M Coombs

© 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.


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