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Found 25 results
  1. Content Article
    Findings: Most of these risk controls – 35 out of 42 – would be classified as ‘administrative’ by the HoC, and thus considered weak. The risk controls that fell into this ‘administrative’ category included training, standardising processes and procedures, and changing the design and organisation of care. Since other evidence shows these approaches can sometimes be very successful in healthcare, it is probably a mistake to automatically assume they are weak. Completely eliminating reliance on human behaviour is very difficult in the healthcare context and would introduc
  2. Content Article
    The book addresses such questions as: What influence will ageing and lack of digital skills in the workforce of the occidental world have on safety culture? What are the likely impacts of big data, artificial intelligence and autonomous technologies on decision-making, and on the roles and responsibilities of individual actors and whole organizations? What role have human beings in a world of accelerating changes? What effects will societal concerns and the entrance of new players have on technological risk management and governance?
  3. Event
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    This free webinar will uncover the intricacies of accident investigation from a human factors perspective. It will feature examples from rail, air and maritime from our speakers who are all specialist human factors investigators. Hear first hand how they tackle investigations and get insights into this vital work that lead to improvements in safety across all travel sectors. Will Tutton will briefly mention the Herald of Free Enterprise, but will mainly talk about the cargo vessel Kaami, which ran aground in Scotland in March 2020. The investigation focused on front line operators. L
  4. Content Article
    The webinar starts with an introduction to the concept of near misses in healthcare and the challenges faced in learning from these near misses to improve safety. You will then hear how near misses are approached in rail and nuclear and how controls are developed in their processes. You will: Gain valuable insights from all three sectors: healthcare, rail and nuclear. Hear discussion about defining near misses with respect to controls. Learn how to build barriers in systems.
  5. Event
    Objectives: Describe the steps involved in conducting RCA of an error. List the tools that can be used during the RCA process. Identify who should be included on a debriefing team and what the ground rules are that will allow a debriefing meeting to be most effective. Register
  6. Event
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    It’s time to register for the 2022 World Patient Safety, Science & Technology Summit, hosted by Patient Safety Movement in the USA. The 2022 World Patient Safety, Science & Technology Summit (WPSSTS) is co-convened by the American Society of Anesthesiologists, the European Society of Anaesthesiology and Intensive Care and the International Society for Quality in Health Care, and will celebrate the Patient Safety Movement Foundation’s first 10 years of achievements. The 2022 WPSSTS will confront leading patient safety issues with actionable ideas and innovations to transform the co
  7. Content Article
    The key topics covered in this video are as follows: What is human factors/ergonomics and how does it relate to healthcare? (at 2 mins and 20 secs) What is the value of high reliability to healthcare? (at 9 mins and 20 secs) How can patient insights and contributions help to create more highly reliable organisations? (at 17 mins and 40 secs) Reflections on the impact of culture and barriers pose to increasing resilience and learning from safety. (at 20 mins and 45 secs) The role of ‘speaking up’ initiatives. (at 25 mins and 40 secs) Incident reporting and
  8. Content Article
    Play video The key topics covered in this video are as follows: Why is high-reliability important in addressing avoidable harm? (at 4 mins 25 secs). How culture impacts on the implementation and use of incident reporting solutions (at 8 mins). How incident reporting rates have changed during the pandemic (at 14 mins 25 secs). Positive reporting and learning from success (at 16 mins 25 secs). The role of Board members and non-executive directors understanding of incident reporting and risk management (at 22 mins 50 secs). Considering the importance of
  9. Content Article
    After watching the video, participants should be better prepared to: Acquire an understanding of the concept of a "medical error". Appreciate the safety movement. Understand the culture of safety. Illustrate real examples of adverse events and their sequelae. Identify a high reliability organisation.
  10. Content Article
    This paper presents eight steps that are recommended for leaders to follow to achieve patient safety and high reliability in their organisations. Step One: Address strategic priorities, culture and infrastructure Step Two: Engage key stakeholders Step Three: Communicate and build awareness Step Four: Establish, oversee and communicate system-level aims Step Five: Track/measure performance over time, strengthen analysis Step Six: Support staff and patients/families impacted by medical errors Step Seven: Align system-wide activities and incentives
  11. Content Article
    Key learning points Two approaches to the problem of human fallibility exist: the person and the system approaches. The person approach focuses on the errors of individuals, blaming them for forgetfulness, inattention, or moral weakness. The system approach concentrates on the conditions under which individuals work and tries to build defences to avert errors or mitigate their effects. High reliability organisations—which have less than their fair share of accidents—recognise that human variability is a force to harness in averting errors, but they work hard t
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