Chapter 15 Human Factors, Patient Safety and Quality Improvement

In recent years, increased emphasis has been placed on the study of healthcare systems to better understand the relationship of how management and administrative systems best support clinical practice and promote quality improvement and patient safety. Today’s healthcare systems face two big challenges: increasing demand because of greater volumes of patients who are older, who often have comorbidities and who often require multidisciplinary care; and an increasing volume of treatment options, often of greater complexity and cost. Patient and societal demands for transparency in defining and justifying treatment decisions impact on all healthcare workers, who need to understand their professional responsibilities when working within complex social and work environments. Patient safety can only be considered in a broader understanding of risk management.

Multiple Choice Questions
Weblinks

Journal article

https://www.bmj.com/content/364/bmj.k5437/ (free)

This paper in the BMJ gives helpful advice about how to get started in quality improvement.

Book

https://www.ncbi.nlm.nih.gov/books/NBK222274/ (open access)

This book recommends changes that will improve the quality, safety and value for money of healthcare in the USA at the level of the individual as well as the broader heathcare system.

Database

https://ihub.scot/improvement-resources/

The Healthcare Improvement Scotland Hub is a valuable website that shares tools and techniques that have been demonstrated to improve quality and safety across a wide range of areas.

White Papers and reports

https://www.kingsfund.org.uk/sites/default/files/field/field_publication_file/Improving-quality-Kings-Fund-February-2016.pdf (free)

The King’s Fund is an independent charitable organisation working to improve health and care in England. This report by improvement leaders outlines the resources and structures available in the NHS to support healthcare improvement.

https://www.england.nhs.uk/signuptosafety/wp-content/uploads/sites/16/2015/10/safety-1-safety-2-whte-papr.pdf (free)

This White Paper describes the factors that increase safety in health care. It encourages us to move our focus from ensuring that ‘as few things as possible go wrong’ to ensuring that ‘as many things as possible go right’.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/226703/Berwick_Report.pdf (free)

This landmark report by healthcare improvement expert Don Berwick looks at challenges in delivering safe health care in England and advocates for continual learning and improvement in the quality and safety of care.

https://www.oecd.org/els/health-systems/The-economics-of-patient-safety-March-2017.pdf (free)

This White Paper demonstrates the human and economic costs of patient harm and identifies ways in which value-based care can also be safer for patients.

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