With unintended harm during hospital care costing billions of dollars to the world economy, not to mention millions of deaths each year, it’s no wonder the issue is equally front and center in the minds of healthcare providers and the public. Although the issue has been tackled in journal articles and conference proceedings, there are very few books on the topic. And none consider how methods and techniques developed in the area of engineering can handle safety and human error-related problems. Until now.
Written by an expert with vast know-how in engineering management, design, reliability, safety, and quality, Patient Safety: An Engineering Approach brings together the pertinent information scattered throughout books and journals, eliminating the need to consult many different and diverse sources to find what you need. B.S. Dhillon draws on his real-world experience to demonstrate how to handle patient safety-related problems using engineering techniques and backs this up with references for further reading at the end of each chapter. He sets the stage with introductory chapters on mathematical, patient safety, and human factors concepts essential to understanding materials presented in subsequent chapters.
Dhillon’s clear, concise discussion of the topics presents the information in such a way that no previous knowledge is required to understand the contents, yet he does not present it at a merely rudimentary level. He brings a fresh approach and engineering perspective to the issues, giving you a new tool kit for performing patient safety-related analysis, designing better medical systems/devices, and handling patient safety-related problems from an engineering perspective.
Introduction
Background
Patient Safety Facts and Figures
Terms and Definitions
Useful Information on Patient Safety
Scope of the Book
Problems
References
Patient Safety Mathematics
Introduction
Range, Mode, Median, Arithmetic Mean, and Mean Deviation
Sets and Boolean Algebra Laws
Probability Definition and Properties
Probability Density Function, Cumulative Distribution Function, and Expected Value Definitions
Probability Distributions
Laplace Transform Definition, Common Laplace Transforms, and Final-Value Theorem
Solving First-Order Differential Equations Using Laplace Transforms
Problems
References
Safety and Human Factors Basics
Introduction
Need for Safety and Safety-Related Facts and Figures
Common Causes of Work Injuries and Classifications of Product Hazards
Common Mechanical Injuries
Accident Causation Theories
Safety Management Principles
Human Factors Objectives and Disciplines Contributing to Human Factors
Human and Machine Characteristics
General Human Behaviors
Human Sensory Capabilities
Human Factors-Related Formulas
Problems
References
Methods for Performing Patient Safety Analysis
Introduction
Failure Modes and Effect Analysis (FMEA)
Root Cause Analysis (RCA)
Hazard Operability Analysis (HAZOP)
Interface Safety Analysis (ISA)
Preliminary Hazard Analysis (PHA)
Technic of Operations Review (TOR)
Job Safety Analysis (JSA)
Six Sigma Methodology
Pareto Diagram
Fault Tree Analysis (FTA)
Markov Method
Problems
References
Patient Safety Basics
Introduction
Patient Safety Goals
Causes of Patient Injuries and Examples of Factors Endangering Patient Safety at Various Levels of Health Care
Patient Safety Culture, Factors Contributing to Patient Safety Culture, and Its Assessment Objectives and Barriers
Safer Practices for Better Health Care
Areas of Improved Patient Safety from Enhanced Health Information Exchange
Patient Safety Program
Patient Safety Indicators
References
Medication Safety and Errors
Introduction
Medication Safety in Emergency Departments
Medication Safety in Operating Rooms
Drug Labeling or Packaging-Related Problems
Prescribing Faults
Medication-Use Safety Indicators
Medication Error-Related Facts and Figures
Medication Errors Types and Common Reasons for Their Occurrence
Nursing-Related Factors in Medication Errors Occurrence
General Guidelines to Reduce the Occurrence of Medication Errors
Problems
References
Health Care Workers’ Role and Safety and Falls
Introduction
Technology Commonly Used by the Nursing Profession
Relationship between Nursing Workload and Patient Safety
Health Care Worker Hazards
Health Care Worker Musculoskeletal and Needlestick Injuries and Latex Allergy
Health Care Workers’ Slip-, Trip-, and Fall-Related Concerns and Prevention Strategies
Inpatient Bed Falls
Wheelchair-Related Falls
Fall Prevention Recommendations for Acute and Long-Term Care
Problems
References
Human Error in Various Medical Areas and Other Related Information
Introduction
Human Error in Anesthesia
Human Error in Emergency Medicine
Human Error in Operating Rooms
Human Error in Intensive Care Units
Human Error in Medical Technology Use, Laboratory Testing, Radiotherapy, and Image Interpretation
Factors Contributing to Human Error in Surgical Pathology and Causes of Wrong-Site Surgeries
Reasons for Clinicians Not Reporting and Disclosing Errors and Near Misses
Guidelines for Preventing the Occurrence of Medical Errors
Health Care Human Error Reporting Systems
Problems
References
Medical Device Safety and Errors
Introduction
Types of Medical Device Safety and Medical Device Hardware and Software Safety
Essential Safety Requirements for Medical Devices, Legal Aspects of Medical Device Safety, and Medical Device Electrical Safety Standards
Software-Related Issues in the Safety of Cardiac Rhythm Management Products
Classifications of Medical Device Accidents and Medical Device Accident Occurrence Probability Estimation
Medical Devices with a High Incidence of Human Error
Medical Device Operator Errors
General Approach to Human Factors during the Medical Device Development Process for Reducing Human Errors
Problems
References
Medical Device Usability
Introduction
Medical Device Users and Use Environments
Medical Device User Interfaces and Use Description
An Approach to Develop Medical Devices’ Effective User Interfaces
Useful Guidelines to Reduce Medical Device/Equipment User-Interface-Related Errors
Designing and Developing Medical Devices for Old User Population
Guidelines for Designing Hand-Operated Devices with Respect to Cumulative Trauma Disorder
Useful Documents for Improving Usability of Medical Devices
Problems
References
Patient Safety Organizations, Data Sources, and Mathematical Models
Introduction
Patient Safety Organization Types and Functions
Governmental Patient Safety Organizations
Independent Patient Safety Organizations
Data Sources
Mathematical Models
Problems
References
Appendix: Bibliography—Literature on Patient Safety
Index
Biography
B.S. Dhillon
" … an outstanding book covering the most up-to-date research translated into simple, easy-to-use methods, procedures and indicators. Dr. Dhillon is an international authority in the field of reliability, safety and human factors engineering and authored over 38 books covering various design and engineering aspects. The highlight of this book is that Dr. Dhillon is applying time-tested, proven engineering best practices to the field of patient safety and is invaluable to healthcare practitioners, administrators, academicians and researchers. It is an excellent, down-to-earth, easy-to-use pragmatic book with up-to-date coverage of literature."
-- Dr. Subramanyam Rayapati, IBM