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This case studies book is an indispensable resource for educators, students, and practitioners of nursing. It is innovative in its application of lessons from the communication sciences to common challenges in the delivery of safe patient care. The authors apply basic tenets of human communication to the context of nursing to provide a foundation for practices that can advance the safety and quality of care. The cases, which describe "close calls" and adverse events, are organized along the continuum of healthcare delivery, providing quick access to solutions in commonly encountered care situations. Each case is accompanied by a discussion of how skillful communication can be key to preventing and recovering from errors and adverse events. Thought-provoking discussion questions and references for further reading make this book a valuable reference for nursing educators, students, and practitioners across the world.
This case studies book is a unique, practical, cutting-edge, and indispensable go-to resource for front-line practitioners and educators in medicine. Each case study (chapter) is framed by a set of introductory learning objectives, an evaluation section, thought-provoking discussion questions, and references to further readings. Furthermore, the book is conveniently organized along the continuum of medical care delivery, providing quick access to ad-hoc solutions in safety- and quality-compromised situations, illustrating how skillful communication can be the key to a more effective prevention, intervention, and response to “close calls” and adverse events. The case studies book is unique and innovative in its interdisciplinary integration of the contemporary literature in communication science with current “hot buttons” of patient safety. It manifests a valuable interdisciplinary collaboration by translating the basic tenets of human communication science for practitioners of medicine, providing a conceptual, evidence-based foundation for formulating communication-based practice guidelines to advance patient safety and quality of care. The case studies put communication theory into practice to facilitate experiential learning, granting insights into the breadth and diverse aspects of safe and high quality healthcare delivery. Thought-provoking discussion questions and references for further reading make this book a valuable reference for medical practitioners across the world.
This case studies book is a unique, practical, cutting-edge, indispensable go-to resource forprofessionals in nursing. Each case study is framed by learning objectives, an evaluation section, thought-provoking discussion questions and references to further readings. The book is conveniently organized along the continuum of medical care delivery, providing quick access to ad-hoc solutions in safety- and quality-compromised situations.
This case studies book is a unique, practical, cutting-edge, and indispensable go-to resource for front-line practitioners and educators in medicine. Each case study (chapter) is framed by a set of introductory learning objectives, an evaluation section, thought-provoking discussion questions, and references to further readings. Furthermore, the book is conveniently organized along the continuum of medical care delivery, providing quick access to ad-hoc solutions in safety- and quality-compromised situations, illustrating how skillful communication can be the key to a more effective prevention, intervention, and response to “close calls” and adverse events. The case studies book is unique and innovative in its interdisciplinary integration of the contemporary literature in communication science with current “hot buttons” of patient safety. It manifests a valuable interdisciplinary collaboration by translating the basic tenets of human communication science for practitioners of medicine, providing a conceptual, evidence-based foundation for formulating communication-based practice guidelines to advance patient safety and quality of care. The case studies put communication theory into practice to facilitate experiential learning, granting insights into the breadth and diverse aspects of safe and high quality healthcare delivery. Thought-provoking discussion questions and references for further reading make this book a valuable reference for medical practitioners across the world.
This case studies book is an indispensable resource for educators, students, and practitioners of nursing. It is innovative in its application of lessons from the communication sciences to common challenges in the delivery of safe patient care. The authors apply basic tenets of human communication to the context of nursing to provide a foundation for practices that can advance the safety and quality of care. The cases, which describe "close calls" and adverse events, are organized along the continuum of healthcare delivery, providing quick access to solutions in commonly encountered care situations. Each case is accompanied by a discussion of how skillful communication can be key to preventing and recovering from errors and adverse events. Thought-provoking discussion questions and references for further reading make this book a valuable reference for nursing educators, students, and practitioners across the world.
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.
This step-by-step guide takes the reader through the complex process of investigating serious incidents in health, social care, and criminal justice environments, acknowledging differences of culture and context that shape an investigation. Taking a multi-disciplinary approach, Part 1 begins by exploring the key principles of investigation, including ethical and legal perspectives, the involvement of families and carers, and being aware of unconscious bias, among other issues. Part 2 outlines in detail the conduct of investigations, from planning to processing the findings, before moving on to Part 3, carrying them out in diverse settings. Further chapters then look at investigating within diverse environments before moving on to to Part 4 which deals with reviewing and analysing the evidence collected and writing up the investigation. This final part also examines the pivotal issue of learning from the investigation and disseminating the report. The inclusion of case studies, models of good practice, and vignettes enables the reader to view each stage of the process in context and drive the transformation of practice. This practical resource is designed to support health and social care professionals who undertake investigations as part of their role, including nurses, allied health practitioners, social workers, doctors, and psychologists, as well as military personnel and law enforcers. It is an essential companion.
Over the last two decades across the globe we have seen a multitude of programs, projects and books to help improve the safety of patient care in healthcare. However, the full potential of these has not yet been reached. Most of the current approaches are top down, programmatic and target driven. These look at problems in isolation one harm at a time with simplistic solutions that fail to support a holistic, systematic approach. They are focused on collecting incident data and learning from failure using tools that are not fit for purpose in a complex nonlinear system. Very rarely do the solutions help build the conditions, cultures and behaviours that support a safer system and help the people involved work safely. Healthcare is stuck in a relentlessly negative approach to safety. Those working in patient safety and healthcare are struggling, and books on patient safety to date instruct the reader to continue doing the same things we have been doing for the last 20 years. This book uniquely combines the latest thinking in safety, including creating a balanced approach to learning from what works as a way to understand why it fails, together with the evidence on building a just culture, positive workplaces and working relationships that we now know are so important for safety. It helps people understand how to address issues despite their complexities and improve safety with practical ways to truly understand what day to day healthcare work is actually like, rather than what people imagine it is like. This book builds on the author’s first book Rethinking Patient Safety which exposed what we need to do differently to truly transform our approach to patient safety. It updates the reader further on the concepts explored in the first book but also vitally helps readers understand the ‘how’. Implementing Patient Safety goes beyond the rhetoric and provides the reader with ideas and examples for how the latest thinking can actually be achieved. It is based on the author’s personal experience of leading a national culture change campaign in the National Health Service for five years. The lessons arise from helping hundreds of organisations and people rethink and implement a whole new way of thinking about improving patient safety in healthcare.
The introduction of a new technology in a consolidated field has the potential to disrupt usual practices and create a fertile ground for errors. An example is robotic surgery that is now used in most surgical specialties, pushed by technology developers and enthusiastic surgeons. To analyze the potential impact of robotic surgery on patient safety, a consortium of major European Universities started the project SAFROS whose findings are summarized and further elaborated in the three parts of this book. Part one describes safety in complex systems such as surgery, how this may disrupt the traditional surgical workflow, how safety can be monitored, and the research questions that must be posed. Part two of the book describes the main findings of this research, by identifying the risks of robotic surgery and by describing where its ancillary technologies may fail. This part addresses features and evaluation of anatomic imaging and modeling, actions in the operating room, robot monitoring and control, operator interface, and surgical training. Part three of the book draws the conclusions and offers suggestions on how to limit the risks of medical errors. One possible approach is to use automation to monitor and execute parts of an intervention, thus suggesting that robotics and artificial intelligence will be major elements of the operating room of the future.