Danino Julian, Muzaffar Jameel, Metcalfe Chris, Coulson Chris
Queen Elizabeth Hospital Birmingham, Birmingham, B15 2TH, England, UK.
Eur Arch Otorhinolaryngol. 2017 Mar;274(3):1317-1326. doi: 10.1007/s00405-016-4291-z. Epub 2016 Sep 13.
Human evaluation and judgement may include errors that can have disastrous results. Within medicine and healthcare there has been slow progress towards major changes in safety. Healthcare lags behind other specialised industries, such as aviation and nuclear power, where there have been significant improvements in overall safety, especially in reducing risk of errors. Following several high profile cases in the USA during the 1990s, a report titled "To Err Is Human: Building a Safer Health System" was published. The report extrapolated that in the USA approximately 50,000 to 100,000 patients may die each year as a result of medical errors. Traditionally otolaryngology has always been regarded as a "safe specialty". A study in the USA in 2004 inferred that there may be 2600 cases of major morbidity and 165 deaths within the specialty. MEDLINE via PubMed interface was searched for English language articles published between 2000 and 2012. Each combined two or three of the keywords noted earlier. Limitations are related to several generic topics within patient safety in otolaryngology. Other areas covered have been current relevant topics due to recent interest or new advances in technology. There has been a heightened awareness within the healthcare community of patient safety; it has become a major priority. Focus has shifted from apportioning blame to prevention of the errors and implementation of patient safety mechanisms in healthcare delivery. Type of Errors can be divided into errors due to action and errors due to knowledge or planning. In healthcare there are several factors that may influence adverse events and patient safety. Although technology may improve patient safety, it also introduces new sources of error. The ability to work with people allows for the increase in safety netting. Team working has been shown to have a beneficial effect on patient safety. Any field of work involving human decision-making will always have a risk of error. Within Otolaryngology, although patient safety has evolved along similar themes as other surgical specialties; there are several specific high-risk areas. Medical error is a common problem and its human cost is of immense importance. Steps to reduce such errors require the identification of high-risk practice within a complex healthcare system. The commitment to patient safety and quality improvement in medicine depend on personal responsibility and professional accountability.
人为评估和判断可能会出现错误，而这些错误可能会导致灾难性后果。在医学和医疗保健领域，在安全方面实现重大变革的进展一直缓慢。医疗保健行业落后于其他专业行业，如航空和核电行业，这些行业在整体安全方面有了显著改善，尤其是在降低错误风险方面。在20世纪90年代美国发生几起备受瞩目的案件后，一份题为《人皆有过：构建更安全的医疗体系》的报告发表了。该报告推断，在美国，每年约有5万至10万名患者可能因医疗错误而死亡。传统上，耳鼻喉科一直被视为一个“安全的专业领域”。2004年美国的一项研究推断，该专业领域可能存在2600例严重发病病例和165例死亡病例。通过PubMed界面在MEDLINE上搜索了2000年至2012年发表的英文文章。每篇文章都结合了前面提到的两三个关键词。局限性与耳鼻喉科患者安全中的几个一般主题相关。由于近期的兴趣或技术新进展，其他涵盖的领域一直是当前相关主题。医疗保健界对患者安全的认识有所提高；它已成为一个主要优先事项。重点已从归咎责任转向预防错误以及在医疗服务中实施患者安全机制。错误类型可分为因行动导致的错误和因知识或规划导致的错误。在医疗保健领域，有几个因素可能会影响不良事件和患者安全。虽然技术可能会提高患者安全，但它也引入了新的错误来源。与他人合作的能力有助于增加安全保障。团队合作已被证明对患者安全有有益影响。任何涉及人类决策的工作领域总是存在错误风险。在耳鼻喉科领域，虽然患者安全的发展与其他外科专业领域有相似的主题；但也有几个特定的高风险领域。医疗错误是一个常见问题，其人力成本至关重要。减少此类错误的步骤需要在复杂的医疗保健系统中识别高风险做法。医学中对患者安全和质量改进的承诺取决于个人责任和专业问责制。
