If a great man makes a mistake, he realizes it.
Having realized it, he admits it.
Having admitted it, he corrects it.
He considers those who point out his faults as his most benevolent teachers.

Lao Tzu (c.604 - 531 B.C.)

Safety in healthcare

Primum non nocere is a Latin phrase that means First do no harm. It is a fundamental principle for medical services all around the world. The physicians and the other healthcare providers must always consider the possible harm that any clinical intervention might do.
The concept of patient Safety implies the prevention of errors and of adverse events associated with the healthcare.
Every point in the process of care-giving contains a certain degree of inherent unsafety. Slight mistakes accumulate and grow to gross errors if unchecked.
Adverse events may result from problems in practice, products, procedures or systems.
Patient Safety improvements demand a complex system-wide effort, involving a wide range of actions for performance improvement, environmental safety and risk management (infection control, safe use of medicines, equipment safety, safe clinical practice, safe environment of care, adoption of guidelines, protocols, procedures, best practice).
While healthcare has become more effective, it has also become more complex with greater use of new technologies, medicines and treatments. Health services treat sick patients who often present with significant co-morbidities requiring even more difficult decisions as to healthcare priorities. Increasing economic pressure on health systems often leads to overloaded healthcare environments.
Unexpected and unwanted events can take place in any setting where healthcare is produced and delivered (lab and research center, primary-secondary-tertiary care centers, community care, social and private care, acute and chronic care).
It has been estimated that every 10th patient experiences preventable harm or adverse events inside the hospital, causing suffering and loss for the patient, the family and the healthcare providers and also taking a high financial toll on healthcare systems.
Reported rates of medical errors -possibly overinflated by the media- are shocking. It has been estimated that approximately 225,000 deaths per year are caused directly by the medical care itself (medication errors and unnecessary healthcare treatment). This makes the medical errors the third leading cause of death in the United States, after heart diseases and cancer.
Given the current social and judicial climate about the clinical malpractice phenomenon, defensive medicine is increasingly practiced by healthcare professionals. The fear of litigation, more than the fear of reprimand, stops actions to prevent future errors and also damages the doctor-patient relationship.
Poor communication often prompts patients to files lawsuits in the first place. I’m sorry laws, which hold expressions of apology, fault or sympathy to be inadmissible as evidence of an admission of liability, are an important step in the right direction toward achieving a balance that encourage transparency between physicians and patients and pave the way for better care over all.
Healthcare must achieve Safety successes already seen in other high-risk industries such as aviation and we must learn to balance Safety, Quality and Accountability.
For caregivers who knowingly and recklessly violate safe practice, discipline is the right course.
But most errors that lead to patient harm occur because of bad systems or bad processes, not because of bad people.

Healthcare Safety and Accountability
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