Value by Design: Developing Clinical Microsystems to Achieve Organizational Excellence, Second Edition

Chapter 3. IMPROVING SAFETY AND ANTICIPATING HAZARDS IN CLINICAL MICROSYSTEMS

Gautham K. Suresh

Marjorie M. Godfrey

Eugene C. Nelson

Paul B. Batalden

LEARNING OBJECTIVES

• Describe the frequency and scope of medical errors in health care systems.

• Differentiate between medical errors and adverse events.

• Compare and contrast the person approach versus the systems approach to patient safety in microsystems.

• List four methods to identify medical errors and adverse events.

• Discuss work conditions, human conditions, and organizational factors that affect patient safety.

• Describe how microsystem members should respond to medical errors and adverse events within their microsystem.

• Describe the five hallmarks that constitute mindfulness in a clinical microsystem.