Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
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Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz · Jan 2015
[Patient safety: a topic of the future, the future of the topic].
Almost 10 years ago, the German Coalition for Patient Safety (Aktionsbündnis Patientensicherheit) was founded as a cooperation covering most institutions of the German health care system. As in other countries facing the issue of patient safety, methods for the analysis of "never events" have been developed, instruments for the identification of the "unknown unknowns" have been established (e.g., CIRS), and the paradigm of individual blame has been replaced by organizational, team and management factors. After these first steps, further developments can only be achieved in so far as patient safety is understood as a system property, which leads to specific implications for the further evolution of the healthccare system. ⋯ All these issues are only to be implemented as far as the general societal attitude supportings further improvement of patient safety and is ready to regard it as a major aim for future developments. Cost arguments alone - costs of suboptimal safety can be estimated to around
1 billion in Germany per year - are considered as insufficient to guarantee further improvements because other issues in the healthcare system show similar magnitudes. As a consequence, ethical implications remain as major arguments for ongoing professional and public discussions. -
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz · Jan 2015
[Patient safety in Sweden].
This article describes the patient safety work in Sweden and the cooperation between the Nordic countries in the area of patient safety. It depicts the national infrastructure, methods and partners in patient safety work as well as the development in key areas. Since 2000, the interest in patient safety and quality issues has significantly increased. ⋯ The Nordic collaboration in this field currently focuses on the development of indicators and quality measurement with respect to nosocomial infections, harm in inpatient somatic care, patient safety culture, hospital mortality and polypharmacy in the elderly. The Nordic collaboration is driven by the development, exchange and documentation of experiences and evidence on patient safety indicators. The work presented in this article is only a part of the Swedish and the Nordic efforts related to patient safety and provides an interesting insight into how this work can be carried out.
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Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz · Jan 2015
[Simulation-based training in anesthesia and emergency medicine: preparation for the unexpected: on the way to new standards of education in Germany].
Medical expertise consists of knowledge, professional skills and individual attitudes. Training and education of this expertise starts in medical school and develops throughout the qualification process of anesthesists and emergency physicians. Medical decisions are not only rational but also intuitive. ⋯ This training goes far beyond the level of skills training. Through simulation training involves the whole team, the communication and the interaction between the team members in medically challenging situations. Crisis resource management leads to measurable improvements in patient safety and safety culture as well as personnel satisfaction.
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Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz · Jan 2015
[Endorsement of risk management and patient safety by certification of conformity in health care quality assessment].
Certification of conformity in health care should provide assurance of compliance with quality standards. This also includes risk management and patient safety. Based on a comprehensive definition of quality, beneficial effects on the management of risks and the enhancement of patient safety can be expected from certification of conformity. ⋯ Advancing safety culture and "climate", as well as learning from adverse events rely in part on quality management and are at least in part reflected in the certification of healthcare quality. However, again, evidence of the effectiveness of such measures is limited. Moreover, additional factors related to personality, attitude and proactive action of healthcare professionals are crucial factors in advancing risk management and patient safety which are currently not adequately reflected in certification of conformity programs.
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Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz · Jan 2015
[Systemic error analysis as a key element of clinical risk management].
Systemic error analysis plays a key role in clinical risk management. This includes all clinical and administrative activities which identify, assess and reduce the risks of damage to patients and to the organization. The clinical risk management is an integral part of quality management. ⋯ It focuses on the analysis of the following contributory factors: patient factors, task and process factors, individual factors, team factors, occupational and environmental factors, psychological factors, organizational and management factors and institutional context. Organizations can only learn from mistakes by analyzing these factors systemically and developing appropriate corrective actions. This article describes the fundamentals and implementation of the method at the University Medical Center Hamburg-Eppendorf.