Patel Vimla L, Kannampallil Thomas G, Shortliffe Edward H
Center for Cognitive Studies in Medicine and Public Health, The New York Academy of Medicine, New York, New York, USA Department of Biomedical Informatics, Arizona State University, Phoenix, Arizona, USA.
Center for Cognitive Studies in Medicine and Public Health, The New York Academy of Medicine, New York, New York, USA Department of Family Medicine, College of Medicine, University of Illinois at Chicago, Illinois, USA.
BMJ Qual Saf. 2015 Jul;24(7):468-74. doi: 10.1136/bmjqs-2014-003482. Epub 2015 May 2.
Given the complexities of current clinical practice environments, strategies to reduce clinical error must appreciate that error detection and recovery are integral to the function of complex cognitive systems. In this review, while acknowledging that error elimination is an attractive notion, we use evidence to show that enhancing error detection and improving error recovery are also important goals. We further show how departures from clinical protocols or guidelines can yield innovative and appropriate solutions to unusual problems. This review addresses cognitive approaches to the study of human error and its recovery process, highlighting their implications in promoting patient safety and quality. In addition, we discuss methods for enhancing error recognition, and promoting suitable responses, through external cognitive support and virtual reality simulations for the training of clinicians.
鉴于当前临床实践环境的复杂性，减少临床错误的策略必须认识到，错误检测和恢复是复杂认知系统功能不可或缺的一部分。在本综述中，虽然承认消除错误是一个有吸引力的概念，但我们用证据表明，增强错误检测和改善错误恢复也是重要目标。我们还进一步展示了偏离临床方案或指南如何能产生针对异常问题的创新且恰当的解决方案。本综述探讨了研究人为错误及其恢复过程的认知方法，强调了它们在促进患者安全和质量方面的意义。此外，我们讨论了通过外部认知支持和虚拟现实模拟来培训临床医生，以增强错误识别并促进适当反应的方法。
