Medical Error and Patient Safety: Human Factors in Medicine

Book Preface

The medical error problem has been recognized as something very serious in terms of avoidable patient injury, achieving efficacious treatment, and controlling health care costs. The prevention of medical errors may seem to be a relatively simple task, and with heightened awareness, some improvements have been reported. However, the search for reasonable, acceptable, and more effective remedies and countermeasures continues with ever-greater vigor. Medical error has proved to be a difficult and recalcitrant phenomenon.

The contents of this book provide a source of useful ideas, concepts, and techniques that could be selectively applied to reduce an intolerable rate of unacceptable errors, mistakes, goofs, or shortcomings in expected human performance. With better understanding, knowledge, and directed motivation, there should be rapid advancement in the medical error management discipline.

This is a companion book for the treatise Human Error: Causes and Control published in 2006 by CRC/Taylor and Francis Group. That book provides supplemental information and insight that may be useful in the task of appropriately controlling the causes of unwanted error. Since medical error is situation-specific and involves diverse human performance, the choice of appropriate preventive and corrective techniques is critical.

This book is written to be comprehensible and instructive for students, thought provoking and useful for expert specialists, and interesting and stimulating for those involved in research. The contents present many ideas within a fairly broad perspective, so the reader may pick the concepts or cherries that seem ripe and appropriate, discard those that seem overripe or not appropriate to a particular situation, and return later when the unripe ideas have matured in the personal experience of the reader and may then meet the reader’s needs. There may be strong arguments against some concepts or applications, as may be expected, but such disagreements should stimulate research that will help in medical error management practices.

The methodology utilized may produce differing results based on exactly how it is applied. A preventive program requires considerable professional discretion, social sensitivity, and compliance with ethical responsibilities and constraints. We have attempted to provide useful information, but it is the reader’s responsibility to fully comprehend the concepts, correctly identify the needs, and undertake appropriate actions. That effort is well worthwhile since success can be measured in lives saved, injuries avoided, health care improvements, and cost reductions.