Improving Patient Safety : Tools and Strategies for Quality Improvement book cover
1st Edition

Improving Patient Safety
Tools and Strategies for Quality Improvement





ISBN 9781498785020
Published January 28, 2019 by Productivity Press
298 Pages 15 B/W Illustrations

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Book Description

Based on the IOM's estimate of 44,000 deaths annually, medical errors rank as the eighth leading cause of death in the U.S. Clearly medical errors are an epidemic that needs to be contained. Despite these numbers, patient safety and medical errors remain an issue for physicians and other clinicians. This book bridges the issues related to patient safety by providing clinically relevant, vignette-based description of the areas where most problems occur. Each vignette highlights a particular issue such as communication, human facturs, E.H.R., etc. and provides tools and strategies for improving quality in these areas and creating a safer environment for patients.

Table of Contents



Preface



Editors



List of Contributors





1 Introduction to Patient Safety and Medical Errors



NAKUL KATYAL





2 Developing an Outline for Patient Safety Curriculum



NAKUL KATYAL





3 Understanding System Errors





Section 1 Human Factors Engineering



Clinical Vignette 1: Every Sound Alarms



DANISH KHERANI





Clinical Vignette 2: Man and His Machine



AHMER ASIF





Clinical Vignette 3: Expensive Gift



ANUDEEP YELAM





Section 2 Communication Issues



Clinical Vignette 1: Doctors Are from Mars and Nurses Are from Venus!



TRIPTI CHOPADE





Clinical Vignette 2: Different Paths Yet the Same Goal



TRIPTI CHOPADE





Clinical Vignette 3: It Was Erik’s Fault!



TRIPTI CHOPADE





Clinical Vignette 4: You Are Not Alone!



TRIPTI CHOPADE





Section 3 Culture of Patient Safety



Clinical Vignette 1: A Husband’s Worst Nightmare



EMILY BAILEY





Clinical Vignette 2: A Big No-No



EMILY BAILEY





Clinical Vignette 3: Alice in Wonderland



NIDHI SHANKAR KIKKERI, LAURA QI, AND SHIVARAJ NAGALLI





Clinical Vignette 4: A Doctor’s Curse



SUGANIYA SRIKANTHAN





Clinical Vignette 5: The Real Price of Smoking?



AHMER ASIF





Clinical Vignette 6: A Rainy Night



NIDHI SHANKAR KIKKERI AND LAURA QI





Clinical Vignette 7: Customer Service 101



KEERTHANA KUMAR





Clinical Vignette 8: The Empty Crash Cart



KEERTHANA KUMAR





Clinical Vignette 9: A Punch in the Face



SIREESHA MURALA





Clinical Vignette 10: As the Kings So Are the Subjects



SIREESHA MURALA





Clinical Vignette 11: The Encrypted Message



KEERTHANA KUMAR





Section 4 Electronic Medical Records and Patient Safety



Clinical Vignette 1: Rubik’s Cube



ANUDEEP YELAM





Clinical Vignette 2: A Hurried Miss



ANUDEEP YELAM





Clinical Vignette 3: A Case of Mistaken Identity



ANUDEEP YELAM





4 Understanding Diagnostic Errors



Clinical Vignette 1: Is First Love the True Love?



HARLEEN KAUR





Clinical Vignette 2: Experience Is the Teacher of All Things or Is It?



HARLEEN KAUR





Clinical Vignette 3: The Man with the Black Coat



HARLEEN KAUR





Clinical Vignette 4: Don’t Question Me!



HARLEEN KAUR





Clinical Vignette 5: Trouble with the Curve



HARLEEN KAUR





Clinical Vignette 6: The New Epidemic



HARLEEN KAUR





5 Understanding Human/Provider Errors



Clinical Vignette 1: Does Age Bring Wisdom?



HARLEEN KAUR





Clinical Vignette 2: The Zero-Sum Game



HARLEEN KAUR





Clinical Vignette 3: Do We Owe our

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Author(s)

Biography

Raghav Govindarajan, MD is a board certified neurologist and neuromuscular physician with a deep and personal interest in patient safety and medical errors. He was a victim of a medication error which caused long term complications affecting his liver, consequences he still faces today. With this personal experience as well as that of his patients, he has a strong passion for patient safety with particular interest in avoiding communication errors. He is currently an assistant professor and an associate clerkship director of neurology at the University of Missouri. In his current position, he has close interaction with medical students and residents with whom he constantly shares patient safety stories and lessons learned from it. Dr. Govindarajan has a strong background in teaching having won 10 teaching and mentorship awards. He also has been awarded the "Golden Doc" award by the Arnold P. Gold Foundation for providing compassionate and patient-centered care, in addition to the compassionate care award by the Schwartz Foundation. He is the founding member and advisor of Gold Humanism Honor Society at the University of Missouri. Dr. Govindarajan has strong leadership experience having been elected as president-elect of his county medical society and serves as the director of clinical quality improvement and outcomes, physician leader of Clinical Quality Improvement Workgroup and physician leader of the committee. He is the author of numerous articles and case reports in peer-reviewed journals.



Harleen Kaur, MD is a clinical researcher at University of Missouri Columbia, Department of neurology. She has strong passion patient safety and quality improvement which was triggered after experiencing a personal tragic event that affected the care of one of her loved ones. In addition to multiple publications and presentations she has a strong passion for patient centered care.





Anudeep Yelam, MD is a clinical researcher at University of Missouri Columbia, Department of neurology. He has a significant experience working as a volunteer physician in multiple rural hospitals providing care to the underserved population. It is this experience in rural medicine that prompted his interest in developing system based care and use of technology to improve the quality of care in rural settings.