RT Book, Section
A1 Wachter, Robert M.
SR Print(0)
ID 56251341
T1 Chapter 14. Reporting Systems, Root Cause Analysis, and Other Methods of Understanding Safety Issues
T2 Understanding Patient Safety, 2e
YR 2012
FD 2012
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-176578-7
LK accessmedicine.mhmedical.com/content.aspx?aid=56251341
RD 2024/04/20
AB In  the  late  1990s,  as  patients,  reporters,  and  legislators  began  to  appreciate  the  scope  of  the  medical  errors  problem,  the  response  was  nearly  Pavlovian:  we  need  more  reporting!  This  commonsensical  appeal  had  roots  in  several  places,  including  the  knowledge  that  transparency  often  drives  change,  the  positive  experiences  with  reporting  in  the  commercial  aviation  industry,1  the  desire  by  many  interested  parties  (patients,  legislators,  the  media,  healthcare  leaders)  to  understand  the  dimensions  of  the  safety  problem,  and  the  need  of  individual  healthcare  organizations  to  know  which  problems  to  work  on.