To Err Is Human

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Publisher : National Academies Press
ISBN 13 : 0309068371
Total Pages : 312 pages
Book Rating : 4.3/5 (9 download)

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Book Synopsis To Err Is Human by : Institute of Medicine

Download or read book To Err Is Human written by Institute of Medicine and published by National Academies Press. This book was released on 2000-03-01 with total page 312 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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

Improving Diagnosis in Health Care

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Publisher : National Academies Press
ISBN 13 : 0309377722
Total Pages : 473 pages
Book Rating : 4.3/5 (93 download)

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Book Synopsis Improving Diagnosis in Health Care by : National Academies of Sciences, Engineering, and Medicine

Download or read book Improving Diagnosis in Health Care written by National Academies of Sciences, Engineering, and Medicine and published by National Academies Press. This book was released on 2015-12-29 with total page 473 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.

Crossing the Quality Chasm

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Publisher : National Academies Press
ISBN 13 : 0309132967
Total Pages : 359 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Crossing the Quality Chasm by : Institute of Medicine

Download or read book Crossing the Quality Chasm written by Institute of Medicine and published by National Academies Press. This book was released on 2001-07-19 with total page 359 pages. Available in PDF, EPUB and Kindle. Book excerpt: Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.

A Sea of Broken Hearts

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Publisher : AuthorHouse
ISBN 13 : 146709711X
Total Pages : 180 pages
Book Rating : 4.4/5 (67 download)

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Book Synopsis A Sea of Broken Hearts by : John T. James Ph.D

Download or read book A Sea of Broken Hearts written by John T. James Ph.D and published by AuthorHouse. This book was released on 2007-07-12 with total page 180 pages. Available in PDF, EPUB and Kindle. Book excerpt: This is a must-read for summer runners, baby-boomers, and anyone who suspects that they or a loved one has been harmed by medical errors in our health care system. Hundreds of thousands of Americans die each year from medical errors, but most mistakes are kept secret from patients. After learning a few basic tools of cardiology, the reader shares a journey of heartbreaking mystery and discovery as a father pieces together the events that led to the death of his 19-year old son, despite extensive evaluation by a team of cardiologists. That personal struggle opens into a broad-ranging examination of our profit-driven health care system. The story concludes with an appeal for ten patients rights to protect us all before we personally encounter the dangers of our health care system.

Preventing Medication Errors

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Publisher : National Academies Press
ISBN 13 : 0309133734
Total Pages : 480 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Preventing Medication Errors by : Institute of Medicine

Download or read book Preventing Medication Errors written by Institute of Medicine and published by National Academies Press. This book was released on 2006-12-11 with total page 480 pages. Available in PDF, EPUB and Kindle. Book excerpt: In 1996 the Institute of Medicine launched the Quality Chasm Series, a series of reports focused on assessing and improving the nation's quality of health care. Preventing Medication Errors is the newest volume in the series. Responding to the key messages in earlier volumes of the seriesâ€"To Err Is Human (2000), Crossing the Quality Chasm (2001), and Patient Safety (2004)â€"this book sets forth an agenda for improving the safety of medication use. It begins by providing an overview of the system for drug development, regulation, distribution, and use. Preventing Medication Errors also examines the peer-reviewed literature on the incidence and the cost of medication errors and the effectiveness of error prevention strategies. Presenting data that will foster the reduction of medication errors, the book provides action agendas detailing the measures needed to improve the safety of medication use in both the short- and long-term. Patients, primary health care providers, health care organizations, purchasers of group health care, legislators, and those affiliated with providing medications and medication- related products and services will benefit from this guide to reducing medication errors.

The Poet's Mistake

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Publisher : Princeton University Press
ISBN 13 : 0691203768
Total Pages : 296 pages
Book Rating : 4.6/5 (912 download)

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Book Synopsis The Poet's Mistake by : Erica McAlpine

Download or read book The Poet's Mistake written by Erica McAlpine and published by Princeton University Press. This book was released on 2020-06-09 with total page 296 pages. Available in PDF, EPUB and Kindle. Book excerpt: What our tendency to justify the mistakes in poems reveals about our faith in poetry—and about how we read Keats mixed up Cortez and Balboa. Heaney misremembered the name of one of Wordsworth's lakes. Poetry—even by the greats—is rife with mistakes. In The Poet's Mistake, critic and poet Erica McAlpine gathers together for the first time numerous instances of these errors, from well-known historical gaffes to never-before-noticed grammatical incongruities, misspellings, and solecisms. But unlike the many critics and other readers who consider such errors felicitous or essential to the work itself, she makes a compelling case for calling a mistake a mistake, arguing that denying the possibility of error does a disservice to poets and their poems. Tracing the temptation to justify poets' errors from Aristotle through Freud, McAlpine demonstrates that the study of poetry's mistakes is also a study of critical attitudes toward mistakes, which are usually too generous—and often at the expense of the poet's intentions. Through remarkable close readings of Wordsworth, Keats, Browning, Clare, Dickinson, Crane, Bishop, Heaney, Ashbery, and others, The Poet's Mistake shows that errors are an inevitable part of poetry's making and that our responses to them reveal a great deal about our faith in poetry—and about how we read.

An Essay on Criticism ...

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Publisher :
ISBN 13 :
Total Pages : 54 pages
Book Rating : 4.R/5 (5 download)

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Book Synopsis An Essay on Criticism ... by : Alexander Pope

Download or read book An Essay on Criticism ... written by Alexander Pope and published by . This book was released on 1711 with total page 54 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Blue Threat

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Publisher :
ISBN 13 : 9780984206308
Total Pages : 256 pages
Book Rating : 4.2/5 (63 download)

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Book Synopsis Blue Threat by : Tony Kern

Download or read book Blue Threat written by Tony Kern and published by . This book was released on 2009-09 with total page 256 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Making Healthcare Safe

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Publisher : Springer Nature
ISBN 13 : 3030711234
Total Pages : 450 pages
Book Rating : 4.0/5 (37 download)

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Book Synopsis Making Healthcare Safe by : Lucian L. Leape

Download or read book Making Healthcare Safe written by Lucian L. Leape and published by Springer Nature. This book was released on 2021-05-28 with total page 450 pages. Available in PDF, EPUB and Kindle. Book excerpt: This unique and engaging open access title provides a compelling and ground-breaking account of the patient safety movement in the United States, told from the perspective of one of its most prominent leaders, and arguably the movement’s founder, Lucian L. Leape, MD. Covering the growth of the field from the late 1980s to 2015, Dr. Leape details the developments, actors, organizations, research, and policy-making activities that marked the evolution and major advances of patient safety in this time span. In addition, and perhaps most importantly, this book not only comprehensively details how and why human and systems errors too often occur in the process of providing health care, it also promotes an in-depth understanding of the principles and practices of patient safety, including how they were influenced by today’s modern safety sciences and systems theory and design. Indeed, the book emphasizes how the growing awareness of systems-design thinking and the self-education and commitment to improving patient safety, by not only Dr. Leape but a wide range of other clinicians and health executives from both the private and public sectors, all converged to drive forward the patient safety movement in the US. Making Healthcare Safe is divided into four parts: I. In the Beginning describes the research and theory that defined patient safety and the early initiatives to enhance it. II. Institutional Responses tells the stories of the efforts of the major organizations that began to apply the new concepts and make patient safety a reality. Most of these stories have not been previously told, so this account becomes their histories as well. III. Getting to Work provides in-depth analyses of four key issues that cut across disciplinary lines impacting patient safety which required special attention. IV. Creating a Culture of Safety looks to the future, marshalling the best thinking about what it will take to achieve the safe care we all deserve. Captivatingly written with an “insider’s” tone and a major contribution to the clinical literature, this title will be of immense value to health care professionals, to students in a range of academic disciplines, to medical trainees, to health administrators, to policymakers and even to lay readers with an interest in patient safety and in the critical quest to create safe care.

Keeping Patients Safe

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Publisher : National Academies Press
ISBN 13 : 0309187362
Total Pages : 485 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Keeping Patients Safe by : Institute of Medicine

Download or read book Keeping Patients Safe written by Institute of Medicine and published by National Academies Press. This book was released on 2004-03-27 with total page 485 pages. Available in PDF, EPUB and Kindle. Book excerpt: Building on the revolutionary Institute of Medicine reports To Err is Human and Crossing the Quality Chasm, Keeping Patients Safe lays out guidelines for improving patient safety by changing nurses' working conditions and demands. Licensed nurses and unlicensed nursing assistants are critical participants in our national effort to protect patients from health care errors. The nature of the activities nurses typically perform â€" monitoring patients, educating home caretakers, performing treatments, and rescuing patients who are in crisis â€" provides an indispensable resource in detecting and remedying error-producing defects in the U.S. health care system. During the past two decades, substantial changes have been made in the organization and delivery of health care â€" and consequently in the job description and work environment of nurses. As patients are increasingly cared for as outpatients, nurses in hospitals and nursing homes deal with greater severity of illness. Problems in management practices, employee deployment, work and workspace design, and the basic safety culture of health care organizations place patients at further risk. This newest edition in the groundbreaking Institute of Medicine Quality Chasm series discusses the key aspects of the work environment for nurses and reviews the potential improvements in working conditions that are likely to have an impact on patient safety.

Human Error

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Publisher : Cambridge University Press
ISBN 13 : 9780521314190
Total Pages : 324 pages
Book Rating : 4.3/5 (141 download)

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Book Synopsis Human Error by : James Reason

Download or read book Human Error written by James Reason and published by Cambridge University Press. This book was released on 1990-10-26 with total page 324 pages. Available in PDF, EPUB and Kindle. Book excerpt: This 1991 book is a major theoretical integration of several previously isolated literatures looking at human error in major accidents.

Cross-cultural Perspectives in Medical Ethics

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Publisher : Jones & Bartlett Learning
ISBN 13 : 9780763713324
Total Pages : 404 pages
Book Rating : 4.7/5 (133 download)

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Book Synopsis Cross-cultural Perspectives in Medical Ethics by : Robert M. Veatch

Download or read book Cross-cultural Perspectives in Medical Ethics written by Robert M. Veatch and published by Jones & Bartlett Learning. This book was released on 2000 with total page 404 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cross- Cultural Perspectives in Medical Ethics, Second Edition, is an anthology of the latest and best readings on the medical ethics of as many of the major religious, philosophical, and medical traditions that are available today.

Understanding Patient Safety, Second Edition

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Publisher : McGraw Hill Professional
ISBN 13 : 0071808124
Total Pages : 501 pages
Book Rating : 4.0/5 (718 download)

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Book Synopsis Understanding Patient Safety, Second Edition by : Robert Wachter

Download or read book Understanding Patient Safety, Second Edition written by Robert Wachter and published by McGraw Hill Professional. This book was released on 2012-05-23 with total page 501 pages. Available in PDF, EPUB and Kindle. Book excerpt: Complete coverage of the core principles of patient safety Understanding Patient Safety, 2e is the essential text for anyone wishing to learn the key clinical, organizational, and systems issues in patient safety.The book is filled with valuable cases and analyses, as well as up-to-date tables, graphics, references, and tools -- all designed to introduce the patient safety field to medical trainees, and be the go-to book for experienced clinicians and non-clinicians alike. Features NEW chapter on the critically important role of checklists in medical practice NEW case examples throughout Expanded coverage of the role of computers in patient safety and outcomes Expanded coverage of new patient initiatives from the Joint Commission

Patient Safety

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Publisher : CRC Press
ISBN 13 : 143985226X
Total Pages : 254 pages
Book Rating : 4.4/5 (398 download)

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Book Synopsis Patient Safety by : Sidney Dekker

Download or read book Patient Safety written by Sidney Dekker and published by CRC Press. This book was released on 2016-04-19 with total page 254 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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

A Human Error Approach to Aviation Accident Analysis

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Author :
Publisher : Routledge
ISBN 13 : 1351962353
Total Pages : 174 pages
Book Rating : 4.3/5 (519 download)

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Book Synopsis A Human Error Approach to Aviation Accident Analysis by : Douglas A. Wiegmann

Download or read book A Human Error Approach to Aviation Accident Analysis written by Douglas A. Wiegmann and published by Routledge. This book was released on 2017-12-22 with total page 174 pages. Available in PDF, EPUB and Kindle. Book excerpt: Human error is implicated in nearly all aviation accidents, yet most investigation and prevention programs are not designed around any theoretical framework of human error. Appropriate for all levels of expertise, the book provides the knowledge and tools required to conduct a human error analysis of accidents, regardless of operational setting (i.e. military, commercial, or general aviation). The book contains a complete description of the Human Factors Analysis and Classification System (HFACS), which incorporates James Reason's model of latent and active failures as a foundation. Widely disseminated among military and civilian organizations, HFACS encompasses all aspects of human error, including the conditions of operators and elements of supervisory and organizational failure. It attracts a very broad readership. Specifically, the book serves as the main textbook for a course in aviation accident investigation taught by one of the authors at the University of Illinois. This book will also be used in courses designed for military safety officers and flight surgeons in the U.S. Navy, Army and the Canadian Defense Force, who currently utilize the HFACS system during aviation accident investigations. Additionally, the book has been incorporated into the popular workshop on accident analysis and prevention provided by the authors at several professional conferences world-wide. The book is also targeted for students attending Embry-Riddle Aeronautical University which has satellite campuses throughout the world and offers a course in human factors accident investigation for many of its majors. In addition, the book will be incorporated into courses offered by Transportation Safety International and the Southern California Safety Institute. Finally, this book serves as an excellent reference guide for many safety professionals and investigators already in the field.

Medication Errors

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Publisher : American Pharmacist Associa
ISBN 13 : 1582120927
Total Pages : 707 pages
Book Rating : 4.5/5 (821 download)

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Book Synopsis Medication Errors by : Michael Richard Cohen

Download or read book Medication Errors written by Michael Richard Cohen and published by American Pharmacist Associa. This book was released on 2007 with total page 707 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this expanded 600+ page edition, Dr. Cohen brings together some 30 experts from pharmacy, medicine, nursing, and risk management to provide the most current thinking about the causes of medication errors and strategies to prevent them.

Patient Safety

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Publisher : National Academies Press
ISBN 13 : 0309090776
Total Pages : 551 pages
Book Rating : 4.3/5 (9 download)

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Book Synopsis Patient Safety by : Institute of Medicine

Download or read book Patient Safety written by Institute of Medicine and published by National Academies Press. This book was released on 2003-12-20 with total page 551 pages. Available in PDF, EPUB and Kindle. Book excerpt: Americans should be able to count on receiving health care that is safe. To achieve this, a new health care delivery system is needed â€" a system that both prevents errors from occurring, and learns from them when they do occur. The development of such a system requires a commitment by all stakeholders to a culture of safety and to the development of improved information systems for the delivery of health care. This national health information infrastructure is needed to provide immediate access to complete patient information and decision-support tools for clinicians and their patients. In addition, this infrastructure must capture patient safety information as a by-product of care and use this information to design even safer delivery systems. Health data standards are both a critical and time-sensitive building block of the national health information infrastructure. Building on the Institute of Medicine reports To Err Is Human and Crossing the Quality Chasm, Patient Safety puts forward a road map for the development and adoption of key health care data standards to support both information exchange and the reporting and analysis of patient safety data.