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A new approach to safety, based on systems thinking, that is more effective, less costly, and easier to use than current techniques. Engineering has experienced a technological revolution, but the basic engineering techniques applied in safety and reliability engineering, created in a simpler, analog world, have changed very little over the years. In this groundbreaking book, Nancy Leveson proposes a new approach to safety—more suited to today's complex, sociotechnical, software-intensive world—based on modern systems thinking and systems theory. Revisiting and updating ideas pioneered by 1950s aerospace engineers in their System Safety concept, and testing her new model extensively on real-world examples, Leveson has created a new approach to safety that is more effective, less expensive, and easier to use than current techniques. Arguing that traditional models of causality are inadequate, Leveson presents a new, extended model of causation (Systems-Theoretic Accident Model and Processes, or STAMP), then shows how the new model can be used to create techniques for system safety engineering, including accident analysis, hazard analysis, system design, safety in operations, and management of safety-critical systems. She applies the new techniques to real-world events including the friendly-fire loss of a U.S. Blackhawk helicopter in the first Gulf War; the Vioxx recall; the U.S. Navy SUBSAFE program; and the bacterial contamination of a public water supply in a Canadian town. Leveson's approach is relevant even beyond safety engineering, offering techniques for “reengineering” any large sociotechnical system to improve safety and manage risk.
The contributions to this book are the invited papers presented at the fifth annual Safety-critical Systems Symposium. They cover a broad spectrum of issues affecting safety, from a philosophical appraisal to technology transfer, from requirements analysis to assessment, from formal methods to artificial intelligence and psychological aspects. They touch on a number of industry sectors, but are restricted to none, for the essence of the event is the transfer of lessons and technologies between sectors. All address practical issues and of fer useful information and advice. Contributions from industrial authors provide evidence of both safety con sciousness and safety professionalism in industry. Smith's on safety analysis in air traffic control and Rivett's on assessment in the automotive industry are informative on current practice; Frith's thoughtful paper on artificial intelli gence in safety-critical systems reflects an understanding of questions which need to be resolved; Tomlinson's, Alvery's and Canning's papers report on collaborative projects, the first on results which emphasise the importance of human factors in system development, the second on the development and trial of a comprehensive tool set, and the third on experience in achieving tech nology transfer - something which is crucial to increasing safety.
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
This book offers a new, practical approach to healthcare reform. Departing from the priorities applied in traditional approaches, it instead assesses – both theoretically and practically – the successful lessons learned in other safety-critical industries, and applies them to healthcare settings. The authors focus on the importance of human factors and performance measures to establish proactive, systematic methods for healthcare system design. This approach helps to identify potential hazards before accidents occur, enhancing patient safety. In addition, the book details the new approach on the basis of real-world applications in the NHS and insights from NHS staff. Case studies and results are presented, demonstrating the significant improvements that can be achieved in risk reduction and safety culture. Lastly, the book outlines what steps healthcare organisations need to take in order to successfully adopt this new approach. The approach and experiential learning is brought together through the development of a new holistic patient safety education syllabus.
This important and timely book contains vital information for all developers working with C, whether in high-integrity areas or not, who need to produce reliable and effective software.
The authors of this book set out a system of safety strategies and interventions for managing patient safety on a day-to-day basis and improving safety over the long term. These strategies are applicable at all levels of the healthcare system from the frontline to the regulation and governance of the system. There have been many advances in patient safety, but we now need a new and broader vision that encompasses care throughout the patient’s journey. The authors argue that we need to see safety through the patient’s eyes, to consider how safety is managed in different contexts and to develop a wider strategic and practical vision in which patient safety is recast as the management of risk over time. Most safety improvement strategies aim to improve reliability and move closer toward optimal care. However, healthcare will always be under pressure and we also require ways of managing safety when conditions are difficult. We need to make more use of strategies concerned with detecting, controlling, managing and responding to risk. Strategies for managing safety in highly standardised and controlled environments are necessarily different from those in which clinicians constantly have to adapt and respond to changing circumstances. This work is supported by the Health Foundation. The Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK. The charity’s aim is a healthier population in the UK, supported by high quality health care that can be equitably accessed. The Foundation carries out policy analysis and makes grants to front-line teams to try ideas in practice and supports research into what works to make people’s lives healthier and improve the health care system, with a particular emphasis on how to make successful change happen. A key part of the work is to make links between the knowledge of those working to deliver health and health care with research evidence and analysis. The aspiration is to create a virtuous circle, using what works on the ground to inform effective policymaking and vice versa. Good health and health care are vital for a flourishing society. Through sharing what is known, collaboration and building people’s skills and knowledge, the Foundation aims to make a difference and contribute to a healthier population.
Since the publication of the second edition several United States jurisdictions have mandated consideration of inherently safer design for certain facilities. Notable examples are the inherently safer technology (IST) review requirement in the New Jersey Toxic Chemical Prevention Act (TCPA), and the Inherently Safer Systems Analysis (ISSA) required by the Contra Costa County (California) Industrial Safety Ordinance. More recently, similar requirements have been proposed at the U.S. Federal level in the pending EPA Risk Management Plan (RMP) revisions. Since the concept of inherently safer design applies globally, with its origins in the United Kingdom, the book will apply globally. The new edition builds on the same philosophy as the first two editions, but further clarifies the concept with recent research, practitioner observations, added examples and industry methods, and discussions of security and regulatory issues. Inherently Safer Chemical Processes presents a holistic approach to making the development, manufacture, and use of chemicals safer. The main goal of this book is to help guide the future state of chemical process evolution by illustrating and emphasizing the merits of integrating inherently safer design process-related research, development, and design into a comprehensive process that balances safety, capital, and environmental concerns throughout the life cycle of the process. It discusses strategies of how to: substitute more benign chemicals at the development stage, minimize risk in the transportation of chemicals, use safer processing methods at the manufacturing stage, and decommission a manufacturing plant so that what is left behind does not endanger the public or environment.
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.
"This is one of the most important Agile books since The Phoenix Project." —Charles Betz, Principle Analyst, Forrester Research It's no secret that we are living in the Digital Age. Technology companies make up seven of the world's ten largest firms by market capitalization. And the key to their success is the key to all modern organizations. Jonathan Smart, business agility practitioner, thought leader, and coach, reveals the patterns and antipatterns that will help organizations from every industry deliver better value sooner, safer, and happier through high levels of engagement, inclusion, and empowerment. Through his decades of experience in the technology world, Smart provides business leaders with a blueprint for creating a world-class organization of the future. Through Agile and Lean ways of working, business leaders can empower teams to improve production, grow together, and create better services for their customers. These better ways of working have overflowed from the IT department to every corner of successful organizations, taking root in every industry from aerospace to accounting, insurance to shipping. This book is not about software development. It is not a book about the computer industry. This book is about applying agility across the entire organization. It's a book that will put you at the front of change and ahead of the competition. "A true business-wide perspective on Digital Transformation and the need for whole business agility." —Adam Banks, Non Executive Director and Former CTIO of AP Moller Maersk **Note from the Authors: Purchases will result in the planting of trees and empowerment of women, in countries with the lowest scores on the IUCN's gender and environment index. It's not just carbon neutral, purchases in any format will result in, on average, 10x greater carbon offset.
While a quick response can save you in a time of crisis, avoiding a crisis remains the best defense. When dealing with complex industrial systems, it has become increasingly obvious that preparedness requires a sophisticated understanding of human factors as they relate to the functional characteristics of socio-technology systems. Edited by indust