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Even though errors form part of every practice, majority of errors are a direct result of complex processes which are preventable. The error in medicine has been described as “the failure of the planned action to be…
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Download file to see previous pages Active errors assume different forms including lapses; this involves failures in memory that prevents the planned actions from being implemented. Slips; this involves performing a familiar action in a wrong away. Mistakes; are refereed to as a trend of reasoning leading to wrong outcome of choices. Latent conditions refer to systemic properties that result to errors. They may include system interfaces and management practices. It is summarized by the descriptions of Don Berwick that “every system is perfectly designed to achieve exactly the results it gets.”
The nature of today’s primary care and frenetic pace of management in care within medical practices have made the probabilities of errors to become great. The Robert Graham Policy Centre has come up with a patient safety model called “toxic cascades.” It describes how small unnoticed errors can add up to become torrents. Research studies on office-based errors in primary care have been found to be of different categories. It shows that communication problems results into 24% of the errors, 20% are caused by discontinuity of care, 13% are as a result of missing charts, 19% from lab results, 8% are caused by clinical mistake, 8% resulted from prescribing errors, and the other 8% by other errors.
The study revealed that medical errors are by and large a result of latent conditions and not active failure as had been believed. The medical infrastructure has become fragile and the risk adverse outcomes has gone low, despite the fact that delayed care, patient dissatisfaction, and worsening illness are still very common concerns in medical practices. Studies on error in health care by the National Patient Safety Foundation (NPSF’s) have led to the conclusion that “the ambulatory inpatient dichotomy is a false one. We have to think about populations and their continuum of care.” (Brennan, 2000).
Turnbull the executive director of NPSF’s has put ...Download file to see next pagesRead More
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