Social Psychology Arena

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• Price: $34.95 $31.46
• Paperback: 261 pages
• Published: May 2011
• ISBN: 978-1-4398522-5-5
• Publisher: CRC Press

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Increased concern for patient safety has put the issue at the top of the agenda of practitioners, hospitals, and even governments. The risks to patients are many and diverse, and the complexity of the healthcare system that delivers them is huge. Yet the discourse is often oversimplified and underdeveloped. Written from a scientific, human factors perspective, Patient Safety: A Human Factors Approach delineates a method that can enlighten and clarify this discourse as well as put us on a better path to correcting the issues.

People often think, understandably, that safety lies mainly in the hands through which care ultimately flows to the patient—those who are closest to the patient, whose decisions can mean the difference between life and death, between health and morbidity. The human factors approach refuses to lay the responsibility for safety and risk solely at the feet of people at the sharp end. That is where we should intervene to make things safer, to tighten practice, to focus attention, to remind people to be careful, to impose rules and guidelines. The book defines an approach that looks relentlessly for sources of safety and risk everywhere in the system—the designs of devices; the teamwork and coordination between different practitioners; their communication across hierarchical and gender boundaries; the cognitive processes of individuals; the organization that surrounds, constrains, and empowers them; the economic and human resources offered; the technology available; the political landscape; and even the culture of the place.

The breadth of the human factors approach is itself testimony to the realization that there are no easy answers or silver bullets for resolving the issues in patient safety. A user-friendly introduction to the approach, this book takes the complexity of health care seriously and doesn’t over simplify the problem. It demonstrates what the approach does do, that is offer the substance and guidance to consider the issues in all their nuance and complexity.

Table of Contents

Medical Competence and Patient Safety

Competence as Individual Virtue or Systems Issue?

Why the Difference in Competence Assumptions?

Good Doctoring and the Pursuit of Perfection

Standardization and the Fear of Scientific-Bureaucratic Medicine

The Expectation of Perfection versus the Inevitability of Mistake

Key Points

References

The Problem of "Human Error" in Healthcare

Numbers Are Strong

The Human Factors Approach

Human Error as Attribution and Starting Point

"I Knew This Could Happen!"

The Local Rationality Principle

Key Points

References

Cognitive Factors of Healthcare Work

Attentional Dynamics

Knowledge Factors

Strategic Factors

Key Points

References

New Technology, Automation, and Patient Safety

The Substitution Myth

Data Overload

Automation Surprises

Evaluating and Testing Medical Technology

Key Points

References

Safety Culture and Organizational Risk

Safety Culture and Drifting into Failure

Risk as Energy to Be Contained

Risk as Complexity

Risk as the Gradual Acceptance of the Abnormal

Risk as a Managerial or Control Problem

Key Points

References

Practical Tools for Creating Safety

Safety Reporting and Organizational Learning

Adverse Event Investigations

Human Factors and Resource Management Training

Briefings and Checklists

Key Points

References

Accountability and Learning from Failure

Learning and Accountability—Just Culture

Criminalization of Medical Error: A Growing Problem?

The Second Victim

Key Points

References

New Frontiers in Patient Safety: Complexity and Systems Thinking

Complicated versus Complex

Newton, Components, and Complexity

The Cartesian-Newtonian Worldview and Adverse Events

Key Points

References

Index

Author/Editor Biography

About the author: Sidney Dekker (PhD, The Ohio State University, 1996) is Professor and Director of the Key Centre for Ethics, Law, Justice and Governance at Griffith University, Brisbane, Australia. He was previously Professor and Director of the Leonardo da Vinci Center for Complexity and Systems Thinking at Lund University, Sweden, and Professor of Community Health Science at the Faculty of Medicine, University of Manitoba, Canada. He has been Visiting Professor at the Alfred Hospital in Melbourne, Australia. He recently became active as airline pilot, flying the Boeing 737.