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Communicating openly with patients and their carers and obtaining consent A patient-centred approach by medical sta ff , with involvement of patients and their carers as partners, is now recognised as being of fundamental importance. There are better treatment...

HUMAN FACTORS The healthcare setting has become increasingly complex. Patient and societal demands for transparency in defining and justifying treatment decisions impact on all healthcare workers, who need to understand their professional responsibilities when ...

Hospital level Clinical governance Patient safety requires a team approach. Many national and international bodies, professional organisations and medical and academic health centres now realise the importance of leadership training. Motivated and well-prepare...

INCIDENTS Understanding the concepts underlying patient safety inci - dents is useful because it helps to anticipate situations that are - likely to lead to errors and highlights areas where preventative action can be taken. The problem of error can be view e...

International Since 2009, WHO has embarked on a series of global and regional initiatives to improve surgical outcomes. Much of this work has stemmed from WHO’s Second Global Patient Safety Challenge, Safe Surgery Saves Lives . One specific strategy that has b...

INTRODUCTION In recent years, increased emphasis has been placed on the study of healthcare systems to better understand the relation ship of how management and administrative systems best support clinical practice and promote quality improvement and patient...

Lean Lean improvement methodologies originated in industrial settings among frontline workers and were pioneered in Japan, - giving rise to much of the terminology used. Kaizen is the Japa - nese word for improvement. A single ‘cycle’ of kaizen activity - is ...

Learning objectives To learn: The importance of understanding human behaviour, • quality and value in healthcare delivery The importance of human factors and teamworking in • reducing and rectifying error Medical error and its de /f_i nitions, including advers...

Low- and middle-income countries Resource-poor countries share many of the aspirations and challenges of resource-rich countries; however, they also face issues that require di ff erent strategies. The probability of a patient being harmed in hospital is gre...

Model for improvement Based on the teachings of W . Edwards Deming ( Table 15.4 ), the model for improvement is a system popularised by the Institute for Healthcare Improvement that asks three ques - tions: ‘What are we trying to accomplish?’, ‘How will we kn...

Never events Many national health services and institutions now require that all incidents are managed, reported and investigated. Incidents can be defined as events that could have or did result in unintended and/or unnecessary serious harm. One subset of seri...

PATIENT SAFETY AND RISK MANAGEMENT Patient safety can only be considered in a broader understand ing of risk management. Healthcare risk management has traditionally focused on the important role of patient safety and the reduction of medical error. However...

PATIENT SAFETY AND THE SURGEON: PROFESSIONAL RESPONSIBILITY Among medical specialties, surgery is one of the most invasive healthcare interventions that a patient can experience. More than 100 million people worldwide undergo surgical treatment every year. Pr...

PATIENT SAFETY Medicine will never be risk-free. From the beginning of train - ing, doctors are taught that errors are unacceptable and that the philosophy of primum non nocere (first, do no harm) should - permeate all aspects of treatment. Y et, worldwide, d...

Prescribing safely Patients are vulnerable to mistakes made in any one of the many steps involved in the ordering, dispensing and admin istration of medications. Medication errors are one of the most common errors across all medical specialties. Accuracy requ...

QUALITY MEASURES Measurement is a key principle of quality improvement. Although many changes take place in health care, without measurement it is impossible to determine whether those changes actually result in improved quality . Measurement of improvement r...

Resource-rich countries Many countries and professional bodies in resource-rich coun - tries have developed various strategies to improve outcomes in surgical practice. These include: /uni25CF regulatory systems for the licensing of physicians and healthcare ...

STRATEGIES FOR PATIENT SAFETY As safety is everybody’s business, building and embedding a safety culture into surgical service delivery is the key to improving patient outcomes. At an institutional level, defining ‘best practice’ within a robust governance syst...