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Understanding Patient Safety, Third Edition

Understanding Patient Safety, Third Edition

9781259860249
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Opis

Now revised and updated—the landmark patient safety primer written by the worlds leading authorities 

Medical errors are the unfortunate byproduct of an increasingly complex healthcare system. Now more than ever, keeping patients safe takes well-trained caregivers, relevant insights from a range of industries, additional investment—and a groundbreaking text like Understanding Patient Safety.

Understanding Patient Safety is “must read” for those seeking to master the clinical, organizational, and systems issues of patient safety. In this bestselling primer, patient safety pioneer Robert Wachter and Kiran Gupta put all the essential tools and principles at your fingertips. Engaging and accessible, the book is filled with high-yield cases, analyses, tables, graphics, along with key points and references—all designed to help you optimize quality and safety.

Understanding Patient Safety begins with an introduction to patient safety and medical errors. Its second section surveys specific types of medical errors, including those related to surgery, medications, diagnosis, transition and handoff, and infections. The third section covers proven solutions, from establishing reporting systems, to creating a culture of safety. 

The third edition reflects pivotal new developments in the field, including major updates in diagnostic errors, information technology and patient safety, ambulatory safety, and clinician burnout. 

Features:: 

Coverage of human factors and errors at the person-machine interface

Review of workplace issues, including supporting caregivers after major errors

How to organize an effective safety program 

Coordination of patient education and training 

Overview of the malpractice system

Discussion of the patients role





Szczegóły produktu
60709
9781259860249
9781259860249

Opis

Rok wydania
2017
Numer wydania
3
Oprawa
miękka foliowana
Wymiary (mm)
191 x 234
Waga (g)
953
  • SECTION I: AN INTRODUCTION TO PATIENT

    SAFETY AND MEDICAL ERRORS

    Chapter 1

    -          New ways of detecting errors, including Trigger Tools and electronic methods of monitoring

    -          New measures of patient safety

    -          Safety rating systems

    The Nature and Frequency of Medical Errors and Adverse Events

    Adverse Events, Preventable Adverse Events, and Errors

    The Challenges of Measuring Errors and Safety

    The Frequency and Impact of Errors

    Key Points

    References and Additional Readings

    Chapter 2

    Basic Principles of Patient Safety

    The Modern Approach to Patient Safety: Systems Thinking and the Swiss Cheese Model

    Errors at the Sharp End: Slips versus Mistakes

    Complexity Theory and Complex Adaptive Systems

    General Principles of Patient Safety Improvement Strategies

    Key Points

    References and Additional Readings

    Chapter 3

    -          Challenges in prioritizing patient safety given the increased pressure to decrease waste, and improve value, patient experience and access

    Safety, Quality, and Value

    What is Quality?

    The Epidemiology of Quality Problems

    Catalysts for Quality Improvement

    The Changing Quality Landscape

    Quality Improvement Strategies

    Commonalities and Differences Between Quality and Patient Safety

    Value: Connecting Quality (and Safety) to the Cost of Care

    Key Points

    References and Additional Readings

    SECTION II: TYPES OF MEDICAL ERRORS

    Chapter 4

    Medication Errors

    Some Basic Concepts, Terms, and Epidemiology

    Strategies to Decrease Medication Errors

    Key Points

    References and Additional Readings

    Chapter 5

    -          Procedural safety, including role of video review and simulators

    Surgical Errors

    Some Basic Concepts and Terms

    Volume–Outcome Relationships

    Patient Safety in Anesthesia

    Wrong-Site/Wrong-Patient Surgery

    Retained Sponges and Instruments

    Surgical Fires

     Safety in Nonsurgical Bedside Procedures

    Key Points

    References and Additional Readings

    Chapter 6

    -          Update on diagnostic errors (in light of a 2015 IOM report)

    Diagnostic Errors

    Some Basic Concepts and Terms

    Missed Myocardial Infarction: A Classic Diagnostic Error

    Cognitive Errors: Iterative Hypothesis Testing, Bayesian Reasoning, and Heuristics

    Improving Diagnostic Reasoning

    Communication and Information Flow Issues in Diagnostic Errors

    Overdiagnosis

    The Policy Context for Diagnostic Errors

    Key Points

    References and Additional Readings

    Chapter 7

    Human Factors and Errors at the Person–Machine Interface

    Introduction

    Human Factors Engineering

    Usability Testing and Heuristic Analysis

    Applying Human Factors Engineering Principles

    Key Points

    References and Additional Readings

    Chapter 8

    -          Better understanding of the challenges of handoffs and signouts, new best practices

    Transition and Handoff Errors

    Some Basic Concepts and Terms

    Best Practices for Person-to-Person Handoffs

    Site-to-Site Handoffs: The Role of the System

    Best Practices for Site-to-Site Handoffs Other Than Hospital Discharge

    Preventing Readmissions: Best Practices for Hospital Discharge

    Key Points

    References and Additional Readings

    Chapter 9

    Teamwork and Communication Errors

    Some Basic Concepts and Terms

    The Role of Teamwork in Healthcare

    Fixed Versus Fluid Teams

    Teamwork and Communication Strategies

    Key Points

    References and Additional Readings

    Chapter 10

    Healthcare-Associated Infections

    General Concepts and Epidemiology

    Surgical Site Infections

    Ventilator-Associated Pneumonia

    Central Line–Associated Bloodstream Infections

    Catheter-Associated Urinary Tract Infections

    Methicillin-Resistant S. Aureus Infection

    C. Difficile Infection

    What Can Patient Safety Learn from the Approach to Hospital-Associated Infections

    Key Points

    References and Additional Readings

    Chapter 11

    -          Post-hospital syndrome

    Other Complications of Healthcare

    General Concepts

    Venous Thromboembolism Prophylaxis

    Preventing Pressure Ulcers

    Preventing Falls

    Preventing Delirium

    Key Points

    References and Additional Readings

    Chapter 12

    -          Increased emphasis on safety in ambulatory and non-hospital settings

    Patient Safety in the Ambulatory Setting

    General Concepts and Epidemiology

    Hospital Versus Ambulatory Environments

    Improving Ambulatory Safety

    Key Points

    References and Additional Readings

    SECTION III: SOLUTIONS

    Chapter 13

    -          CPOE and EHRs: more on unanticipated  consequences (new kinds of errors, alert fatigue), lack of interoperability

    Information Technology

    Healthcares Information Problem

    Electronic Health Records

    Computerized Provider Order Entry

    Other IT-Related Safety Solutions

    Computerized Clinical Decision Support Systems

    IT Solutions for Improving Diagnostic Accuracy

    The Policy Environment for HIT

    Key Points

    References and Additional Readings

    Chapter 14

    -          Rethinking root cause analysis

    Reporting Systems, Root Cause Analysis, and Other Methods of Understanding Safety Issues

    Overview

    General Characteristics of Reporting Systems

    Hospital Incident Reporting Systems

    The Aviation Safety Reporting System

    Reports to Entities Outside the Healthcare Organization

    Patient Safety Organizations

    Root Cause Analysis and Other Incident Investigation Methods

    Morbidity and Mortality Conferences

    Other Methods of Capturing Safety Problems

    Key Points

    References and Additional Readings

    Chapter 15

    -          Update on checklists

    Creating a Culture of Safety

    Overview

    An Illustrative Case

    Measuring Safety Culture

    Hierarchies, Speaking Up, and the Culture of Low Expectations

    Production Pressures

    Teamwork Training

    Checklists and Culture

    Rules, Rule Violations, and Workarounds

    Some Final Thoughts on Safety Culture

    Key Points

    References and Additional Readings

    Chapter 16

    -          Workforce issues and clinician burnout

    Workforce Issues

    Overview

    Nursing Workforce Issues

    Rapid Response Teams

    House Staff Duty Hours

    The “July Effect”

    Nights and Weekends

    “Second Victims”: Supporting Caregivers After Major Errors

    Key Points

    References and Additional Readings

    Chapter 17         

    -          Safety and medical education (including impact of 2011 duty hours reform and new ACGME patient safety assessment)

    Education and Training Issues

    Overview

    Autonomy Versus Oversight

    Simulation Training

    Teaching Patient Safety

    Key Points

    References and Additional Readings

    Chapter 18

    The Malpractice System

    Overview

    Tort Law and the Malpractice System

    Error Disclosure, Apologies, and Malpractice

    No-Fault Systems and “Health Courts”: An Alternative to Tort-Based Medical Malpractice

    Cases as a Source of Safety Lessons

    Key Points

    References and Additional Readings

    Chapter 19

    Accountability

    Overview

    Accountability

    Disruptive Providers

    The “Just Culture”

    Reconciling “No Blame” and Accountability

    The Role of the Media

    Key Points

    References and Additional Readings

    Chapter 20

    -          Impact of major policy initiatives, including the Affordable Care Act and the Partnership for Patients

    Accreditation and Regulations

    Overview

    Accreditation

    Regulations

    Other Levers to Promote Safety

    Problems with Regulatory, Accreditation, and Other Prescriptive Solutions

    Key Points

    References and Additional Readings

    Chapter 21

    The Role of Patients

    Overview

    Patients with Limited English Proficiency

    Patients with Low Health Literacy

    Errors Caused by Patients Themselves

    Patient Engagement as a Safety Strategy

    Key Points

    References and Additional Readings

    Chapter 22

    -          Learning healthcare systems

    Organizing a Safety Program

    Overview

    Structure and Function

    Managing the Incident Reporting System

    Dealing with Data

    Strategies to Connect Senior Leadership with Frontline Personnel

    Strategies to Generate Frontline Activity to Improve Safety

    Dealing with Major Errors and Sentinel Events

    Failure Mode and Effects Analyses

    Qualifications and Training of the Patient Safety Officer

    The Role of the Patient Safety Committee

    Engaging Physicians in Patient Safety

    Board Engagement in Patient Safety

    Research in Patient Safety

    Patient Safety Meets Evidence-Based Medicine

    Key Points

    References and Additional Readings

    Conclusion

    SECTION IV: APPENDICES

    Appendix I. Key Books, Reports, Series, and Web Sites on Patient Safety

    Appendix II. The AHRQ Patient Safety Network (AHRQ PSNet) Glossary of Selected Terms in Patient Safety

    Appendix III. Selected Milestones in the Field of Patient Safety

    Appendix IV. The Joint Commissions National Patient Safety Goals (Hospital Version, 2011)

    Appendix V. Agency for Healthcare Research and Qualitys (AHRQ) Patient Safety Indicators (PSIs)

    Appendix VI. The National Quality Forums List of Serious Reportable Events,

    Appendix VII. The National Quality Forums List of “Safe Practices for Better Healthcare—2010 Update”

    Appendix VIII. Medicares “No Pay for Errors” List

    Appendix IX. Things Patients and Families Can Do, and Questions They Can Ask, to Improve Their Chances of Remaining Safe in the Hospital

    Index

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