Youngberg Barbara J
Beazley Institute for Health Law and Policy, Loyola University Chicago School of Law, Chicago, Illinois, USA.
Clin Obstet Gynecol. 2008 Dec;51(4):647-55. doi: 10.1097/GRF.0b013e3181899a05.
This article will discuss why patient safety has been so hard to achieve due to long standing beliefs that when errors occur individuals must be blamed or punished. It will offer suggestions as to how a culture of learning can be advanced by fostering a different approach to medical errors and how reporting systems and an analytic process that always identifies root causes of problems can help physicians reduce harm to patients and ultimately malpractice risk.
本文将探讨为何由于长期以来的观念认为一旦出现错误就必须归咎或惩罚个人,患者安全一直难以实现。它将就如何通过培养一种不同的医疗差错处理方式来推动学习文化,以及报告系统和始终能确定问题根本原因的分析流程如何帮助医生减少对患者的伤害并最终降低医疗事故风险提供建议。