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Human reliability and error have become a very important issue in health care, owing to the vast number of associated deaths each year. For example, according to the findings of the Institute of Medicine in 1999, around 100000 Americans die each year because of human error. This makes human error in health care the eighth leading cause of deaths in the US. Moreover, the total annual national cost of the medical errors is estimated at between $17 billion and $37.6 billion.There are very few books on this subject, and none of them covers it at a significant depth. The need for a book presenting the basics of human reliability, human factors and comprehensive information on error in medical systems is essential. This book meets that need.
Author : Institute of Medicine Publisher : National Academies Press Page : 312 pages File Size : 31,96 MB Release : 2000-03-01 Category : Medical ISBN : 0309068371
Experts estimate that as many as 98,000 people die in any given year from medical errors that occur in hospitals. That's more than die from motor vehicle accidents, breast cancer, or AIDSâ€"three causes that receive far more public attention. Indeed, more people die annually from medication errors than from workplace injuries. Add the financial cost to the human tragedy, and medical error easily rises to the top ranks of urgent, widespread public problems. To Err Is Human breaks the silence that has surrounded medical errors and their consequenceâ€"but not by pointing fingers at caring health care professionals who make honest mistakes. After all, to err is human. Instead, this book sets forth a national agendaâ€"with state and local implicationsâ€"for reducing medical errors and improving patient safety through the design of a safer health system. This volume reveals the often startling statistics of medical error and the disparity between the incidence of error and public perception of it, given many patients' expectations that the medical profession always performs perfectly. A careful examination is made of how the surrounding forces of legislation, regulation, and market activity influence the quality of care provided by health care organizations and then looks at their handling of medical mistakes. Using a detailed case study, the book reviews the current understanding of why these mistakes happen. A key theme is that legitimate liability concerns discourage reporting of errorsâ€"which begs the question, "How can we learn from our mistakes?" Balancing regulatory versus market-based initiatives and public versus private efforts, the Institute of Medicine presents wide-ranging recommendations for improving patient safety, in the areas of leadership, improved data collection and analysis, and development of effective systems at the level of direct patient care. To Err Is Human asserts that the problem is not bad people in health careâ€"it is that good people are working in bad systems that need to be made safer. Comprehensive and straightforward, this book offers a clear prescription for raising the level of patient safety in American health care. It also explains how patients themselves can influence the quality of care that they receive once they check into the hospital. This book will be vitally important to federal, state, and local health policy makers and regulators, health professional licensing officials, hospital administrators, medical educators and students, health caregivers, health journalists, patient advocatesâ€"as well as patients themselves. First in a series of publications from the Quality of Health Care in America, a project initiated by the Institute of Medicine
The effective and interrelated functioning of system reliability technology, human factors, and quality play an important role in the appropriate, efficient, and cost-effective delivery of health care. Simply put, it can save you time, money, and more importantly, lives. Over the years a large number of journal and conference proceedings articles o
National Academies of Sciences, Engineering, and Medicine
Author : National Academies of Sciences, Engineering, and Medicine Publisher : National Academies Press Page : 473 pages File Size : 47,12 MB Release : 2015-12-29 Category : Medical ISBN : 0309377722
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.
Human errors contribute significantly to most transportation crashes: approximately 70 to 90 percent of crashes are the result of human error. This book examines human reliability across all types of transportation systems. The material is accessible to readers with no previous knowledge in the field and is supported with a full explanation of the necessary mathematical concepts together with numerous examples and test problems.
Increased concern for patient safety has put the issue at the top of the agenda of practitioners, hospitals, and even governments. The risks to patients are many and diverse, and the complexity of the healthcare system that delivers them is huge. Yet the discourse is often oversimplified and underdeveloped. Written from a scientific, human factors
Examining-room computers require doctors to record detailed data about their patients, yet reduce the time clinicians can spend listening attentively to the very people they are trying to help. This book presents original essays by distinguished experts in their fields, addressing this critical problem and making an urgent case for reform, because while electronic technology has revolutionized the practice of medicine, it also poses a unique challenge to health care. Smartphones in the hands of doctors and nurses have become dangerously seductive devices that can endanger their patients. Distracted Doctoring is written for anesthesiologists and surgeons, as well as general practitioners, nurses, and health care administrators and students. Chapters include Electronic Challenges to Patient Safety and Care; Distraction, Disengagement, and the Purpose of Medicine; and Managing Distractions through Advocacy, Education, and Change.
Background: Despite a focus on improving patient safety and quality of care since the publication of the 2000 report, To Error is Human, there has not been much progress toward preventing adverse medical errors. Many health care organizations are beginning to apply high reliability principles, such as human factors engineering, to help address safety problems. A use of these methods and principles has proven successful in high- risk, complex industries, such as aviation. Like aviation, the health care industry is complex and error prone. Therefore, the experiences cultivated from highly reliable industries might be useful in improving work processes and systems in health care. Purpose: The purpose of this study was to explore the lessons learned from highly reliable industries, such as aviation, by investigating systemic and human factors that led to medical errors in one health care facility. Using the Human Factors Analysis and Classification System (HFACS) to analyze and categorize causal factors from 108 root cause analyses, the study site was able to determine if an association existed between systemic and human factors. Determining what causal factors were most problematic allowed leaders to precisely focus efforts to specific interventions that would alleviate reoccurrence of the errors. Methods: This quantitative exploratory study used descriptive statistics to organize the data alongside higher reliability principles in order to meaningfully evaluate the medical errors. Results: The data analysis resulted in seven major findings, which yielded two overall indicators of focus: (1) attention to efforts that realize zero harm and (2) managing processes that effectively reduce systemic issues. Conclusion: Leadership’s attention to these major focus areas gives insight as to how patient care can be efficiently provided. Likewise, applying human factors engineering principles to medical errors can help improve patient safety, provide empirical knowledge to health care professionals, and increase reliability in the health care industry.
The first edition of Handbook of Human Factors and Ergonomics in Health Care and Patient Safety took the medical and ergonomics communities by storm with in-depth coverage of human factors and ergonomics research, concepts, theories, models, methods, and interventions and how they can be applied in health care. Other books focus on particular human
This edited collection of articles addresses aspects of medical care in which human error is associated with unanticipated adverse outcomes. For the purposes of this book, human error encompasses mismanagement of medical care due to: * inadequacies or ambiguity in the design of a medical device or institutional setting for the delivery of medical care; * inappropriate responses to antagonistic environmental conditions such as crowding and excessive clutter in institutional settings, extremes in weather, or lack of power and water in a home or field setting; * cognitive errors of omission and commission precipitated by inadequate information and/or situational factors -- stress, fatigue, excessive cognitive workload. The first to address the subject of human error in medicine, this book considers the topic from a problem oriented, systems perspective; that is, human error is considered not as the source of the problem, but as a flag indicating that a problem exists. The focus is on the identification of the factors within the system in which an error occurs that contribute to the problem of human error. As those factors are identified, efforts to alleviate them can be instituted and reduce the likelihood of error in medical care. Human error occurs in all aspects of human activity and can have particularly grave consequences when it occurs in medicine. Nearly everyone at some point in life will be the recipient of medical care and has the possibility of experiencing the consequences of medical error. The consideration of human error in medicine is important because of the number of people that are affected, the problems incurred by such error, and the societal impact of such problems. The cost of those consequences to the individuals involved in medical error, both in the health care providers' concern and the patients' emotional and physical pain, the cost of care to alleviate the consequences of the error, and the cost to society in dollars and in lost personal contributions, mandates consideration of ways to reduce the likelihood of human error in medicine. The chapters were written by leaders in a variety of fields, including psychology, medicine, engineering, cognitive science, human factors, gerontology, and nursing. Their experience was gained through actual hands-on provision of medical care and/or research into factors contributing to error in such care. Because of the experience of the chapter authors, their systematic consideration of the issues in this book affords the reader an insightful, applied approach to human error in medicine -- an approach fortified by academic discipline.