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When Things Go Wrong: How Health Care Organizations Deal With Major Failures
Kieran Walshe and
Stephen M. Shortell
Concern about patient safety, caused in part by high-profile major failures in which many patients have been harmed, is rising worldwide. This paper draws on examples of such failures from several countries to analyze how these events are dealt with and to identify lessons and recommendations for policy. Better systems are needed for reporting and investigating failures and for implementing the lessons learned. The culture of secrecy, professional protectionism, defensiveness, and deference to authority is central to such major failures, and preventing future failures depends on cultural as much as structural change in health care systems and organizations.
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L Leape, D Berwick, C Clancy, J Conway, P Gluck, J Guest, D Lawrence, J Morath, D O'Leary, P O'Neill, et al.
Transforming healthcare: a safety imperative
Qual. Saf. Health Care,
December 1, 2009;
18(6):
424 - 428.
[Abstract]
[Full Text]
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T Smith
Culture and incentives conducive to quality and safety in health care
Qual. Saf. Health Care,
August 1, 2004;
13(4):
317 - 320.
[Full Text]
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