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A memoir looking at the ups and downs of a doctor’s life. A ‘warts and all’ examination of the NHS through the last 50 years. The book also looks at the looming crisis in the NHS when the number of doctors will dramatically fall.
Misadventures in Health Care: Inside Stories presents an alternative approach to attributing the cause of medical error solely to the health care provider. That alternative, the systems approach, pursues why an incident occurs in terms of factors in the context of care that affect the care provider to induce an error. The basis for this approach is the fact that an error is an act, an act is behavior, and behavior is a function of the person interacting with the environment. Eleven vignettes illustrate the importance of the systems approach by describing health care incidents from the perspective of the care providers--the perspective that can identify the factors that actually affect the provider. These stories provide general readers with opportunities to apply their knowledge in analyzing incidents to identify error-inducing factors. This book is important reading for policymakers, researchers and practitioners in law and in all medical specialties, and professionals in the social sciences, human factors, and engineering. In addition to sensitizing the reader to the importance of contextual factors in error, Misadventures in Health Care is a case study reference to supplement texts in professional schools such as law and medicine, as well as the full range of academic disciplines. It also is important reading for the general public because it presents an approach for addressing a very pressing social problem-- that of misadventures in health care.
A stripper bitten by a venomous snake, a boy in suspended animation after collapsing in the snow, a woman who survived being run over by a train. These are some of the intriguing and baffling cases I have encountered in my medical career. I have never ceased to be amazed at the bewildering assortment of medical mysteries that have been thrown at me. Some were head scratchers, some were tragic, some amusing. Some defy explanation altogether. They have shown me that people are strange, conflicted, frail and remarkable creatures. They have also shown me how some patients, even when brought to their knees by their ailments, can courageously struggle back onto their feet.These experiences have taught me humility and caution. Faced with events I couldn't control and outcomes that defied all predictions, it often seemed that medicine was a series of traps designed to trip me up or, perhaps, a capricious gremlin whispering confusing advice in my ear and plotting to humiliate me.This collection of stories highlights the murky confusion that doctors face when confronted by the unexpected. They remind us that certainty in medicine is not assured and assumptions can be misleading. The practice of medicine, for better or worse, is a curious mix of science, art and divination and the results are never entirely predictable.
This collection of intriguing stories offers profound insights into medical history. It highlights what all health professionals should know about the career path they have chosen. Each chapter presents a number of fascinating tales of legendary medical innovators, diseases that changed history, insightful clinical sayings, famous persons and their illnesses, and epic blunders made by physicians and scientists. The book relates the stories in history to what clinicians do in practice today and is ideal reading for physicians, residents, medical students and all clinicians.
•A memoir looking at the ups and downs of a doctor’s life. •A ‘warts and all’ examination of the NHS through the last 50 years. •The book also looks at the looming crisis in the NHS when the number of doctors will dramatically fall. Alistair Fraser-Moodie believes he was probably born into medicine. His mother was a general practitioner working from home, his father was a surgeon & also a dentist. Following his ‘destiny’ he started training as a doctor. He recalls 5 years at medical school learning very little about medicine, but a lot about girls, alcohol and sport. Now after 54 years as a doctor, and having recently retired, Alistair has written about his personal journey through the highs and lows of the medical profession. Alistair had many different jobs within the NHS and for a while was a plastic surgeon. But in 1978 he was appointed a single-handed emergency casualty consultant in Derby, a position that is now shared between 16 people. He remained there until 2007. During this time he became an expert in ‘Road Traffic Accidents’ and made many court appearances as an Expert Witness. He writes about many of medical misadventures, dilemmas and curious cases that occurred while in the A&E. Alistair also lays bare the medical problems attributable to, and suffered by, the doctors themselves. He looks at the incredible stress that doctors have to suffer. And many of the problems of the health system which have been made worse by government policies. How sick is the NHS? Well read this uncensored account of a lifetime in the NHS which is both true and for adults only. If you read this book cover to cover then you will see why the NHS is in the mess it is in.Only then, he would maintain, can drastic action be taken.
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.
Properly performing health care systems require concepts and methods that match their complexity. Resilience engineering provides that capability. It focuses on a system’s overall ability to sustain required operations under both expected and unexpected conditions rather than on individual features or qualities. This book contains contributions from international experts in health care, organisational studies and patient safety, as well as resilience engineering. Whereas current safety approaches primarily aim to reduce the number of things that go wrong, Resilient Health Care aims to increase the number of things that go right.
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