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Healthcare facilities have had safety programs in place for many years. The purpose of these programs is to provide an environment in which hazards are eliminated or minimized for employees, staff, patients, and visitors.
Safety is promoted via several activities,
Risk management
Emergency preparedness
hazardous materials management,
Radiation safety,
Environmental safety and hygiene, security, and preventive maintenance.
The person involved usually was blamed for being careless, incompetent, or thoughtless.
Organizations focused on training and hiring competent people, believing they would be less likely to make mistakes. This reliance on healthcare professionals to perform faultlessly was misguided
Patient safety improvement initiatives are an important component of a healthcare organization’s overall quality management effort.
Most mistakes are not intentional but occur because a process is complex. Even simple patient care processes are complex in terms of the variables involved
The hospital process of obtaining a blood specimen for laboratory testing
Report
These groups identified the following five practices as important to increasing the quantity and quality of employee incident reports (O’Leary and Chappell 1996)
Projects aimed at improving patient safety follow the same steps as any other project:
1. Define the improvement goal.
2. Analyze current practices.
3. Design and implement improvements.
4. Measure success
An outpatient clinic could use RCI to reduce prescription errors Two improvement models
are used by healthcare organizations for the explicit purpose of making patient care safer:
failure mode and effects analysis and root cause analysis.
Failure mode and effects analysis (FMEA) is a proactive risk assessment technique that involves a close examination of a process to determine where improvements are needed to reduce the likelihood of adverse events (McDermott, Mikulak, and Beauregard 1996).
Technique
The technique is considered proactive because the improvement project is undertaken to prevent an adverse event. The FMEA technique promotes systematic thinking about the safety of a patient care process in terms of the following questions:
The goal of an FMEA project is to find these hazards and make process changes to reduce the risk of error. FMEA is a formal and systematic assessment process, but individuals informally use FMEA almost every day.
A criticality score is assigned to each potential failure on the basis of the following criteria:
Each of these criteria is rated on a scale of one to five, with one as the lowest possible rating and five as the highest. Once the rating process is complete, a criticality score is assigned to each potential failure.
This score is calculated by multiplying the frequency score by the severity score by the detection score.
score = Frequency score X severity score X detection score
Root cause analysis (RCA) has been used for many years in other industries.
Safety improvement teams use RCA after an adverse event has occurred to determine system deficiencies that led to the event. The six steps involved in RCA follow the Plan-Do-Study-Act Cycle
near miss is an incident that did not result in death or injury but could have; only by chance was the patient not harmed.
The aim of the study (lshaikh, M., Mayet, A., & Aljadhey, H. (2013)) was to explore the reporting rate of medication errors and the factors associated with the root causes of these errors in a large tertiary teaching hospital in Saudi Arabia.
This study was conducted at the University Teaching Hospital, Riyadh, Saudi Arabia.
All incidence/variable reports of medication errors were documented in a hospital web-based medication error form designed to capture information on all aspects.
Medication errors were reviewed and reported at quarterly intervals over one year (November 2009 to October 2010).
Result
Conclusion
Medication errors are underreported in a tertiary
teaching hospital in Riyadh, Saudi Arabia. Future studies should evaluate the effectiveness of interventions to stimulate medication errors
reporting by health-care providers.
1. Spath, P., & DeVane, K. A. (2009). Introduction to healthcare quality management (Vol. 2). Chicago, IL: Health Administration Press.
2. Al-Abbadi, H. A., Basharaheel, H. A., Alharbi, M. R., Alharbi, H. A., Sindi, D., & Bamatraf, M. (2019). Patients’ perspectives of surgical safety before and after their elective Surgeries at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. Cureus, 11(11).
3. Kaldjian, L. C., Jones, E. W., Wu, B. J., Forman-Hoffman, V. L., Levi, B. H., & Rosenthal, G. E. (2008). Reporting medical errors to improve patient safety: a survey of physicians in teaching hospitals. Archives of internal medicine, 168(1), 40-46.
4. Alshaikh, M., Mayet, A., & Aljadhey, H. (2013). Medication error reporting in a university teaching hospital in Saudi Arabia. Journal of patient safety, 9(3), 145-149