To Do No Harm: Safety as a Professional Obligation
That’s why I’m encouraged by IHI’s initiative to have all hospital’s boards spend at least 25 percent of their meeting time on quality and safety issues. Equally important, there is the further goal that the boards have a conversation with at least one patient (or family member of a patient) who sustained serious harm within the last year at their institution.
Moving from the hospital board room to the surgical unit, pre-operation check lists can also help save lives. Simply by calling a time-out prior to making a skin incision in the operating room, and specifically going over the procedure to be done and the instruments to be used, could have a dramatic effect. Complications fall dramatically and outcomes improve significantly when this simple step, as endorsed by the World Health Organization, is taken by the surgical team.
Then there are the ever present medication complications that are all too frequently encountered in a hospital setting, including improperly administered dosages. But this problem can arise even in a patient’s own home. The total number of drugs sitting on a patient’s kitchen table or bathroom shelf can be at times overwhelming, and the prescriptions baffling, to the patient or their family members.
Most chronically ill patients, for example, see many different doctors in multiple clinics, none of whom know what the others have prescribed. Patients look at the line-up of prescription bottles and are befuddled. Either taking too many (with adverse drug reactions occurring) or giving up, and taking none. Readmissions, preventable illness, and occasionally far more serious events (kidney failure) unfortunately can result.
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