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Over the past decade it has been increasingly recognized that medical errors constitute an important determinant of patient safety, quality of care, and clinical outcomes. Such errors are both directly and indirectly responsible for unnecessary and potentially preventable morbidity and/or mortality across our healthcare institutions. The spectrum of contributing variables or "root causes" - ranging from minor errors that escalate, poor teamwork and/or communication, and lapses in appropriate protocols and processes (just to name a few) - is both extensive and heterogeneous. Moreover, effective solutions are few, and many have only recently been described. As our healthcare systems mature and their focus on patient safety solidifies, a growing body of research and experiences emerges to help provide an organized framework for continuous process improvement. Such a paradigm - based on best practices and evidence-based medical principles- sets the stage for hardwiring "the right things to do" into our institutional patient care matrix. Based on the tremendous interest in the first two volumes of The Vignettes in Patient Safety series, this third volume follows a similar model of case-based learning. Our goal is to share clinically relevant, practical knowledge that approximates experiences that busy practicing clinicians can relate to. Then, by using evidence-based approaches to present contemporary literature and potential contributing factors and solutions to various commonly encountered clinical patient safety scenarios, we hope to give our readers the tools to help prevent similar occurrences in the future. In outlining some of the best practices and structured experiences, and highlighting the scope of the problem, the authors and editors can hopefully lend some insights into how we can make healthcare experiences for our patients safer.
Ensuring the delivery of quality, accessible, affordable, and safe healthcare presents an ongoing complex challenge crucial to the progression and advancement of modern healthcare systems. In addition to providing the highest quality health care to patients, healthcare leadership and systems must also provide for the safety and security of healthcare providers throughout the entire, complex healthcare conglomerate, including pre-hospital providers, pharmacists, patient care technicians, radiological technicians, nurses, physical therapists, physician extenders, and physicians. Every aspect of care provided merits consideration for quality improvement, augmenting clinical efficiency, promoting effective, efficient collaboration and coordination between different clinical services, curtailing exorbitant healthcare costs, and boosting patient and provider safety. This third installment of Contemporary Topics in Patient Safety examines a broad variety of interrelated connected themes corresponding to the benefits and challenges of providing safety-focused quality patient care via improved clinical infrastructure, conceptual planning, symbiotic team-building enhancements, and sage leadership. The elements, issues, and dilemmas discussed in this textbook pertain to both resource-replete and resource-challenged nations, and to worldwide health systems, which develop uniquely in response to unique, local conundrums and dilemmas. Topics discussed in this volume address the central factors of identifying and facilitating the promotion of continual advancement of clinical routines and regimens among individuals and medical teams as well as institutional practices towards enhanced safety and improved outcomes.
As healthcare systems continue to evolve, it is clear that providing safe, high-quality care to patients is an extremely complex process. Ranging from multi-disciplinary teams to bedside care, virtually every aspect of the patient-care experience provides us with an opportunity for doing things better, from improving efficiency, safety, and overall outcomes to reducing costs and promoting team synergy. This book, the fifth in our patient safety series collection, consists of chapters that help explore key concepts related to both the safety and quality of care. In a departure from the vignette-driven format of our earlier books, this installment gravitates toward discussing frameworks, theoretical considerations, team-centric approaches, and a variety of other concepts that are critical to both our understanding and the implementation of safer and better-performing health systems. We also feel that the knowledge presented herein increasingly applies across the world, especially as global health systems evolve and mature over time. It is our goal to improve the recognition of potential opportunities that will highlight various aspects of the delivery of healthcare and thus contribute to better patient experiences, with safety at the forefront. Topics covered in this volume, as well as the previous volumes, highlight the critical importance of identifying and addressing opportunities for improvement, not as one-time events, but rather as continuous, hardwired institutional processes.
Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.
Over the past two decades, the healthcare community increasingly recognized the importance and the impact of medical errors on patient safety and clinical outcomes. Medical and surgical errors continue to contribute to unnecessary and potentially preventable morbidity and/or mortality, affecting both ambulatory and hospital settings. The spectrum of contributing variables-ranging from minor errors that subsequently escalate to poor communication to lapses in appropriate protocols and processes (just to name a few)-is extensive, and solutions are only recently being described. As such, there is a growing body of research and experiences that can help provide an organized framework-based upon the best practices and evidence-based medical principles-for hospitals and clinics to foster patient safety culture and to develop institutional patient safety champions. Based upon the tremendous interest in the first volume of our Vignettes in Patient Safety series, this second volume follows a similar vignette-based model. Each chapter outlines a realistic case scenario designed to closely approximate experiences and clinical patterns that medical and surgical practitioners can easily relate to. Vignette presentations are then followed by an evidence-based overview of pertinent patient safety literature, relevant clinical evidence, and the formulation of preventive strategies and potential solutions that may be applicable to each corresponding scenario. Throughout the Vignettes in Patient Safety cycle, emphasis is placed on the identification and remediation of team-based and organizational factors associated with patient safety events. The second volume of the Vignettes in Patient Safety begins with an overview of recent high-impact studies in the area of patient safety. Subsequent chapters discuss a broad range of topics, including retained surgical items, wrong site procedures, disruptive healthcare workers, interhospital transfers, risks of emergency department overcrowding, dangers of inadequate handoff communication, and the association between provider fatigue and medical errors. By outlining some of the current best practices, structured experiences, and evidence-based recommendations, the authors and editors hope to provide our readers with new and significant insights into making healthcare safer for patients around the world.
"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
Contemporary Nursing, Issues, Trends, & Management, 6th Edition prepares you for the rapidly evolving world of health care with a comprehensive yet focused survey of nursing topics affecting practice, as well as the issues facing today's nurse managers and tomorrow's nurse leaders. Newly revised and updated, Barbara Cherry and Susan Jacob provide the most practical and balanced preparation for the issues, trends, and management topics you will encounter in practice. Content mapped to the AACN BSN Essentials emphasizes intraprofessional teams, cultural humility and sensitivity, cultural competence, and the CLAS standards. Vignettes at the beginning of each chapter put nursing history and practice into perspective, followed by Questions to Consider While Reading This Chapter that help you reflect on the Vignettes and prepare you for the material to follow. Case studies throughout the text challenge you to apply key concepts to real-world practice. Coverage of leadership and management in nursing prepares you to function effectively in management roles. Career management strategies include advice for making the transition from student to practitioner and tips on how to pass the NCLEX-RN ® examination. Key terms, learning outcomes, and chapter overviews help you study more efficiently and effectively. Helpful websites and online resources provide ways to further explore each chapter topic. Coverage of nursing education brings you up to date on a wide range of topics, from the emergence of interactive learning strategies and e-learning technology, to the effects of the nursing shortage and our aging nursing population. Updated information on paying for health care in America, the Patient Protection and Affordable Care Act, and statistics on health insurance coverage in the United States helps you understand the history and reasons behind healthcare financing reform, the costs of healthcare, and current types of managed care plans. A new section on health information technology familiarizes you with how Electronic Health Records (EHRs), point-of-care technologies, and consumer health information could potentially impact the future of health care. Updated chapter on health policy and politics explores the effect of governmental roles, structures, and actions on health care policy and how you can get involved in political advocacy at the local, state, and federal level to help shape the U.S. health care system. The latest emergency preparedness and response guidelines from the Federal Emergency Management Agency (FEMA), the Centers for Disease Control (CDC), and the World Health Organization (WHO) prepare you for responding to natural and man-made disasters.
The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.