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Harrison's Principles of Internal Medicine, 18e
| Part 1. Introduction to Clinical Medicine > |
Chapter 10. The Safety and Quality of Health Care
Sections: The Safety and Quality of Health Care: Introduction, Further Readings.
Topics Discussed: cost, access, and quality of health care; health care safety; quality indicators; quality of care.
Excerpt:"The safety and quality of care are two of the central dimensions of health care. It is increasingly clear that both could be much better, and in recent years it has become easier to measure safety and quality. In addition, the public is—with good justification—demanding measurement and accountability, and payment for services increasingly will be based on performance in these areas. Thus, physicians must learn about these two domains, how they can be improved, and the relative strengths and limitations of the current ability to measure them.Safety theory clearly points out that individuals make errors all the time. Think of driving home from the hospital; you intend to stop and pick up a quart of milk on the way home but find yourself entering your driveway without realizing how you got there. Everybody uses low-level, semiautomatic behavior for many activities in daily life; this kind of error is called a "slip." Slips occur often during care delivery, e.g., when people intend to write an order but forget because they have to complete another action first. "Mistakes," by contrast, are errors of a higher level; they occur in new or nonstereotypic situations in which conscious decisions are being made. An example would be dosing a medication with which..."
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