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This synthesis will be of interest to highway department administrators, accident records personnel, information systems and data processing management personnel, highway traffic and safety engineers, drivers' licensing officials, state and local police, as well as federal agencies, industries, traffic safety associations, and others responsible for the collection, analysis, and use of accident data. Information is provided on national accident data banks in addition to state and local practice associated with accident data collection, analysis, and evaluation. This synthesis describes current practice with respect to the characteristics and importance of accident data quality, including the reporting and data collection procedures, the analysis and quality control measures employed, and the communications systems used. This report of the Transportation Research Board discusses accident records systems, including data sources and users, considers the effects of inadequate data on analyses, and reviews data acquisition and processing programs that have had good results in the states using them. Recommendations for improving operating systems and for additional research are included.
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
Examines the EPA's role in the area of chemical accident safety. Attempts to comprehensively evaluate efforts to implement chemical accident safety policies, something which has not previously been attempted. Discusses the EPA's databases on accident occurrence and impact, the EPA's chemical preparedness activities, the effectiveness of the EPA's response to chemical accidents in the past, and the steps the EPA has taken to help prevent chemical accidents. Charts and graphs.
In 2000, Congress asked for a review of the Chemical Safety Board¿s (CSB) effectiveness in carrying out its mission. The report cited problems with CSB¿s governance, mgmt., policies, and procedures. It was recommended that CSB obtain the services of an existing office of Inspector General (IG). Since FY 2001, 3 IGs -- from FEMA, DHS, and EPA -- have provided oversight to CSB. This report examined: (1) how CSB has responded to the recommendations regarding CSB¿s investigative gap, data quality problems, human capital problems, and accountability and mgmt. problems for meeting its mission requirements; and (2) the merits of the current oversight approach using an existing office of IG and other approaches. Ill.
Papers presented in this work reflect the need for everyone involved in the process industries to understand the demands of COMAH regulations. They include contributions on: COMAH - an HSE view and application; chemical and reaction hazards; risk assessment and simulation techniques.
This synthesis will be of interest to highway administrators, safety officials, design engineers, traffic engineers, and analysts who are concerned with improving highway safety. Severity indices, which serve as indicators of the expected injury consequences of a crash, are an integral part of the analysis of proposed roadside safety improvements. Severity indices that have been developed by many states and research agencies are described, as are the issues associated with developing the values, and applying and evaluating the indices. The history of severity indices, the issues associated with estimating accident severity and associated costs, and the range of indices that have been developed are described. This publication of the Transportation Research Board also discusses the relationship of accident severity indices with the American Association of State Highway and Transportation Officials (AASHTO) Roadside Design Guide and the Federal Highway Administration (FHWA) ROADSIDE computer program. While research since the 1960s has sought to quantify severity indices for a range of object types and impact conditions, there remains a wide variation in the values from which analysts may choose when performing cost effectiveness evaluations.