Perspectives on Safety
Our Perspectives on Safety section features expert viewpoints on current themes in patient safety, including interviews and written essays published monthly. Annual Perspectives highlight vital and emerging patient safety topics.
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Approach to Improving Safety
Clinical Area
Interview
In Conversation With… Charles Vincent, MPhil, PhD
Safety in the UK, June 2012
Professor Vincent, a psychologist by training, is one of the world’s leading patient safety researchers.
Interview
In Conversation With… Richard C. Boothman, JD
Disclosing Errors and Other Innovations in Risk Management, March 2012
An attorney and chief risk officer for the University of Michigan Health System, Mr. Boothman developed a pioneering approach to medical mistakes and risk management, emphasizing an honest approach to errors, early apology, and rapid settlement offers when the system was at fault.
Interview
In Conversation with…Thomas H. Gallagher, MD
Patient Disclosure and Apology, January 2009
Thomas H. Gallagher, MD, is Associate Professor in the Department of Medicine and the Department of Medical History and Ethics at the University of Washington in Seattle. Dr. Gallagher's current research covers the disclosure of medical errors, examining patients' and doctors' attitudes about disclosure, how best to train providers to disclose and apologize for errors, and how to create a system that promotes appropriate disclosure. We asked him to speak with us about new developments in the field of patient disclosure and apologies.
Perspective
Disclosure of Medical Error
with commentary by Allen Kachalia, MD, JD, Patient Disclosure and Apology, January 2009
Disclosure of medical error is inextricably linked to today's patient safety efforts. Health care experts advocate that greater disclosure is necessary to achieve complete transparency and ameliorate barriers to error reporting.(1,2) Of course, the ethical obligations triggered by the occurrence of a medical error are not to be overlooked. Principles of fiduciary duty, patient autonomy, and equity all strongly support the ethical and moral mandate for physicians to disclose harmful errors to patients.(3) These principles weigh in favor of disclosure even if it is contrary to the physician's interests (e.g., malpractice risk or reputation). As a result, the issue of disclosure garners tremendous attention in today's medical literature.
Interview
In Conversation with...Allan Frankel, MD
Patient Safety Programs, July 2006
Allan Frankel, MD, is Director of Patient Safety for Partners HealthCare, the merged entity of Harvard hospitals and clinics that includes Massachusetts General and Brigham and Women's Hospital. Dr. Frankel, an anesthesiologist by training, has been a key member of the faculty of the Institute for Healthcare Improvement, co-chairing numerous Adverse Drug Events and Patient Safety Collaboratives. Dr. Frankel's work in patient safety focuses on leadership training, high reliability in health care, teamwork development, and cultural change. We asked Dr. Frankel to speak with us about developing a comprehensive patient safety program.
Perspective
The Wild West: Patient Safety in Office-Based Anesthesia
with commentary by Rainu Kaushal, MD MPH; Sekhar Upadhyayula, MD; David M. Gaba, MD; Lucian L. Leape, MD, Outpatient Safety, May 2006
Over the last decade, surgical operations and interventional procedures have been performed increasingly in offices with the administration of office-based anesthesia (OBA).(1) Economic considerations and convenience have driven this increase. Schultz...
Perspective
The Unfinished Patient Safety Agenda
with commentary by Linda H. Aiken, PhD, RN , Nursing and Patient Safety , July-August 2005
The goal set by the Institute of Medicine (IOM) in 1999 to reduce medical errors by half within 5 years has not been achieved. Opinion polls of consumers and health professionals show that concerns about patient safety remain high. Yet only 16% of hospital...
Perspective
Interpreting the Patient Safety Literature
with commentary by Kaveh G. Shojania, MD, Research in Patient Safety , June 2005
Five years ago, a widely publicized randomized trial reported a 90% reduction in the incidence of contrast dye-induced renal failure when patients were pretreated with acetylcysteine, an agent previously used to treat acetaminophen overdoses and bronchitis...