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107-468: Millennia ago, Hippocrates recognized the potential for injuries that arise from the well-intentioned actions of healers. Greek healers in the 4th century BC drafted the Hippocratic Oath and pledged to "prescribe regimens for the good of my patients according to my ability and my judgment and never do harm to anyone." Since then, the directive primum non nocere ("first do no harm") has become

214-461: A French physician, said that these revivals make up "the whole history of internal medicine." According to Aristotle 's testimony, Hippocrates was known as "The Great Hippocrates". Concerning his disposition, Hippocrates was first portrayed as a "kind, dignified, old country doctor" and later as "stern and forbidding". He is certainly considered wise, of very great intellect and especially as very practical. Francis Adams describes him as "strictly

321-472: A better basis on which to make decisions, in turn leading to better outcomes. Psychological safety has been found to play an important role for both patient safety culture and for enabling quality improvement in the health care setting. Effective communication is essential for ensuring patient safety. Communicating starts with the provisioning of available information on any operational site especially in mobile professional services. Communicating continues with

428-580: A central tenet for contemporary medicine. However, despite an increasing emphasis on the scientific basis of medical practice in Europe and the United States in the late 19th century, data on adverse outcomes were hard to come by and the various studies commissioned collected mostly anecdotal events. In the United States, the public and the medical specialty of anesthesia were shocked in April 1982 by

535-459: A clear purpose and each member should be aware of their role and be involved accordingly. To increase the quality of communication between people involved, regular feedback should be provided. Strategies such as briefings allow the team to be set on their purpose and ensure that members not only share the goal but also the process they will follow to achieve it. Briefings reduce interruptions, prevent delays and build stronger relationships, resulting in

642-560: A communication science model of "Physician Mistake Disclosure." In 2009, Hannawa received her doctorate from ASU. Hannawa received her first academic appointment at Wake Forest University (WFU) in Winston-Salem , North Carolina , USA, as tenure-track assistant professor in the Department of Communication Studies. In 2011, she was appointed to a tenure-track professorship in health communication and research methodology at

749-502: A discipline distinct from other fields with which it had traditionally been associated ( theurgy and philosophy ), thus establishing medicine as a profession. However, the achievements of the writers of the Hippocratic Corpus , the practitioners of Hippocratic medicine, and the actions of Hippocrates himself were often conflated; thus very little is known about what Hippocrates actually thought, wrote, and did. Hippocrates

856-587: A few characteristics that are unique to the pediatric population: One of the main challenges faced by pediatric safety and quality efforts is that most of the work on patient safety to date has focused on adult patients. In addition, there is no standard nomenclature for pediatric patient safety that is widely used. However, a standard framework for classifying pediatric adverse events that offers flexibility has been introduced. Standardization provides consistency between interdisciplinary teams and can facilitate multisite studies. If these large-scale studies are conducted,

963-422: A fixed time after the contraction of a disease. If a crisis occurred on a day far from a critical day , a relapse might be expected. Galen believed that this idea originated with Hippocrates, though it is possible that it predated him. Hippocratic medicine was humble and passive. The therapeutic approach was based on "the healing power of nature" ( Latin : vis medicatrix naturae ). According to this doctrine,

1070-526: A hot iron. Other treatments such as applying various salves are suggested as well. Today, "treatment [for hemorrhoids] still includes burning, strangling, and excising." Also, some of the fundamental concepts of proctoscopy outlined in the Corpus are still in use. For example, the uses of the rectal speculum , a common medical device, are discussed in the Hippocratic Corpus. This constitutes

1177-679: A later physician, Polybus was Hippocrates's true successor, while Thessalus and Draco each had a son named Hippocrates (Hippocrates III and IV). Soranus said that Hippocrates learned medicine from his father and grandfather ( Hippocrates I ), and studied other subjects with Democritus and Gorgias . Hippocrates was probably trained at the asklepieion of Kos, and took lessons from the Thracian physician Herodicus of Selymbria . Plato mentions Hippocrates in two of his dialogues: in Protagoras , Plato describes Hippocrates as "Hippocrates of Kos,

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1284-500: A librarian in Alexandria . The volumes were probably produced by his students and followers. The Hippocratic Corpus contains textbooks, lectures, research, notes and philosophical essays on various subjects in medicine, in no particular order. These works were written for different audiences, both specialists and laymen, and were sometimes written from opposing viewpoints; significant contradictions can be found between works in

1391-544: A long time. The centuries after Hippocrates's death were marked as much by retrograde movement as by further advancement. For instance, "after the Hippocratic period, the practice of taking clinical case-histories died out," according to Fielding Garrison . After Hippocrates, another significant physician was Galen , a Greek who lived from AD 129 to AD 200. Galen perpetuated the tradition of Hippocratic medicine, making some advancements, but also some regressions. In

1498-545: A patient safety incident, compared with those who did not, had In order to reduce these errors the attention to safety needs to concentrate on designing safe systems and processes. Slonim and Pollack point out that safety is critical to reduce medical errors and adverse events. These problems can range from diagnostic and treatment errors to hospital-acquired infections, procedural complications, and failure to prevent problems such as pressure ulcers. In addition to addressing quality and safety issues found in adult patients there are

1605-569: A patient's intravenous access is a clear nursing responsibility. Pediatric patients are at increased risk for intravenous infiltration and for significant complications of infiltration, should it occur. The characteristics of effective indicators of pediatric nursing care quality include the following: Hippocrates Hippocrates of Kos ( / h ɪ ˈ p ɒ k r ə t iː z / , ‹See Tfd› Greek : Ἱπποκράτης ὁ Κῷος , translit.   Hippokrátēs ho Kôios ; c.  460  – c.  370 BC ), also known as Hippocrates II ,

1712-749: A patient's records at any health care site. Still, there may be a weak link because of physicians' deficiencies in understanding the patient safety features of e.g. government approved software. Errors associated with patient misidentification may be exacerbated by EHR use, but inclusion of a prominently displayed patient photograph in the EHR can reduce errors and near misses. Portable offline emergency medical record devices have been developed to provide access to health records during widespread or extended infrastructure failure, such as in natural disasters or regional conflicts. These systems' basic security measures are based on sound identifying electronic tags, in order that

1819-592: A specific patient, with the best available evidence from medical research. The doctor's expertise includes both diagnostic skills and consideration of individual patient's rights and preferences in making decisions about his or her care. The clinician uses pertinent clinical research on the accuracy of diagnostic tests and the efficacy and safety of therapy, rehabilitation, and prevention to develop an individual plan of care. The development of evidence-based recommendations for specific medical conditions, termed clinical practice guidelines or "best practices", has accelerated in

1926-426: A strong patient safety environment. Debriefing is another useful strategy. Healthcare providers meet to discuss a situation, record what they learned and discuss how it might be better handled. Closed loop communication is another important technique used to ensure that the message that was sent is received and interpreted by the receiver. SBAR is a structured system designed to help team members communicate about

2033-456: A tangible concern for healthcare and information technology professionals. As such, the term technological iatrogenesis describes this new category of adverse events that are an emergent property resulting from technological innovation creating system and microsystem disturbances. Healthcare systems are complex and adaptive, meaning there are many networks and connections working simultaneously to produce certain outcomes. When these systems are under

2140-544: A way that best fits their needs, practicing active listening skills, being sensitive with regards to cultural diversity and respecting the privacy and confidentiality rights of the patient. To use appropriate communication technology, healthcare professionals must choose which channel of communication is best suited to benefit the patient. Some channels are more likely to result in communication errors than others, such as communicating through telephone or email (missing nonverbal messages which are an important element of understanding

2247-790: Is a German communication scientist and director of the Center for the Advancement of Healthcare Quality and Safety (CAHQS) at the Università della Svizzera italiana in Lugano . She presides the European Institute for Safe Communication (EISC). Hannawa studied interpersonal communication at San Diego State University , where she earned a master's degree in 2006. She then began her Ph.D. studies in health communication at Arizona State University . Her dissertation developed

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2354-426: Is also important in learning how to avoid these mistakes in the future by conducting quality improvement reviews, or clinical peer review. If the provider accurately handles the event, and disclose it to the patient and their family, he/she can avoid getting punished, which includes lawsuits, fines and suspension. The simplest definition of a health care error is a preventable adverse effect of care, whether or not it

2461-404: Is also known as Hippocratic fingers. Hippocratic succussion is the internal splashing noise of hydropneumothorax or pyopneumothorax . Hippocratic bench (a device which uses tension to aid in setting bones) and Hippocratic cap-shaped bandage are two devices named after Hippocrates. Hippocratic Corpus and Hippocratic Oath are also his namesakes. Risus sardonicus , a sustained spasming of

2568-446: Is also of interest to note that medication errors are also the most preventable type of harm that can occur within the pediatric population. It has been reported that when pediatric medication errors occur, these patients have a higher rate of death associated with the error than adult patients. A more recent review of potential pediatric safety issues conducted by Miller, Elixhauser, and Zhan found that hospitalized children who experienced

2675-768: Is an effort of the Carnegie Mellon School of Computer Science and Shadyside Medical Center , "to develop advanced planning, simulation, and execution technologies for the next generation of computer-assisted surgical robots." Both the Canadian Hippocratic Registry and American Hippocratic Registry are organizations of physicians who uphold the principles of the original Hippocratic Oath as inviolable through changing social times. Hippocrates's legendary genealogy traces his paternal heritage directly to Asklepius and his maternal ancestry to Heracles . According to Tzetzes's Chiliades ,

2782-424: Is commonly portrayed as the paragon of the ancient physician and credited with coining the Hippocratic Oath , which is still relevant and in use today. He is also credited with greatly advancing the systematic study of clinical medicine , summing up the medical knowledge of previous schools, and prescribing practices for physicians through the Hippocratic Corpus and other works. Historians agree that Hippocrates

2889-409: Is evident or harmful to the patient. Errors have been, in part, attributed to: The Joint Commission 's Annual Report on Quality and Safety 2007 found that inadequate communication between healthcare providers, or between providers and the patient and family members, was the root cause of over half the serious adverse events in accredited hospitals. Other leading causes included inadequate assessment of

2996-554: Is mentioned in passing in the writings of two contemporaries: in Plato 's dialogues Protagoras and Phaedrus , and in Aristotle 's Politics , all of which date from the 4th century BC. Soranus wrote that Hippocrates's father was Heraclides , a physician, and his mother was Praxitela, daughter of Tizane. The two sons of Hippocrates, Thessalus and Draco , and his son-in-law, Polybus , were his students. According to Galen ,

3103-467: Is not at risk. This allows a much more complete and clear picture to be formed of the facts of an event. From there, root cause analysis can occur. There are often multiple causative factors involved in an adverse or near miss event. It is only after all contributing factors have been identified that effective changes can be made that will prevent a similar incident from occurring. After an adverse event occurs, each country has its own way of dealing with

3210-498: Is probably the most famous document of the Hippocratic Corpus. Recently, the authenticity of the document's author has come under scrutiny. While the Oath is rarely used in its original form today, it serves as a foundation for other, similar oaths and laws that define good medical practice and morals. Such derivatives are regularly taken by modern medical graduates about to enter medical practice. Although Hippocrates neither founded

3317-405: Is said to be around 50%, this number leads to an increased risk of adverse events that shouldn't happen, anywhere from 26% to 70% higher risk that something bad will happen to the patient. According to a study by RAND Health, the U.S. healthcare system could save more than $ 81 billion annually, reduce adverse healthcare events, and improve the quality of care if health information technology (HIT)

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3424-426: Is said to have measured a patient's pulse when taking a case history to discover whether the patient was lying. Hippocrates extended clinical observations into family history and environment. "To him medicine owes the art of clinical inspection and observation." Hippocrates and his followers were the first to describe many diseases and medical conditions. He is given credit for the first description of clubbing of

3531-414: Is to aid a patient in achieving their optimal health outcome, which entails that the patient's safety is not at risk. Practice of effective communication plays a large role in promoting and protecting patient safety. During complex situations, communication between health professionals must be at its best. There are several techniques, tools, and strategies used to improve communication. Any team should have

3638-400: Is to feed your sickness". However, potent drugs were used on certain occasions. This passive approach was very successful in treating relatively simple ailments such as broken bones, which required traction to stretch the skeletal system and relieve pressure on the injured area. The Hippocratic bench and other devices were used to this end. In Hippocrates's time it was thought that fever

3745-435: Is widely adopted. The most immediate barrier to widespread adoption of technology is cost despite the patient benefit from better health, and payer benefit from lower costs. However, hospitals pay in both higher costs for implementation and potentially lower revenues (depending on reimbursement scheme) due to reduced patient length of stay. The benefits provided by technological innovations also give rise to serious issues with

3852-642: The ABC television program 20/20 entitled The Deep Sleep . Presenting accounts of anesthetic accidents, the producers stated that, every year, 6,000 Americans die or experience brain damage related to these mishaps. In 1983, the British Royal Society of Medicine and the Harvard Medical School jointly sponsored a symposium on anesthesia deaths and injuries, resulting in an agreement to share statistics and to conduct studies. Attention

3959-670: The Asclepiad "; while in Phaedrus , Plato suggests that "Hippocrates the Asclepiad" thought that a complete knowledge of the nature of the body was necessary for medicine. Hippocrates taught and practiced medicine throughout his life, traveling at least as far as Thessaly , Thrace , and the Sea of Marmara . Several different accounts of his death exist. He died, probably in Larissa , at

4066-580: The French doctor M. S. Houdart called the Hippocratic treatment a "meditation upon death". If you want to learn about the health of a population, look at the air they breathe, the water they drink, and the places where they live. Analogies have been drawn between Thucydides' historical method and the Hippocratic method, in particular the notion of "human nature" as a way of explaining foreseeable repetitions for future usefulness, for other times or for other cases. An important concept in Hippocratic medicine

4173-486: The Guidelines International Network , which entertains the largest guideline library worldwide. The International Standard ISO 15189:2007 for Accreditation of Medical Laboratory requires laboratories to continuously monitor and improve the quality of their facilities. Advantages: Drawbacks: Community pharmacy practice is making important advances in the quality and safety movement despite

4280-609: The Knidian and Koan on how to deal with disease. The Knidian school of medicine focused on diagnosis. Medicine at the time of Hippocrates knew almost nothing of human anatomy and physiology because of the Greek taboo forbidding the dissection of humans. The Knidian school consequently failed to distinguish when one disease caused many possible series of symptoms. The Hippocratic school or Koan school achieved greater success by applying general diagnoses and passive treatments. Its focus

4387-657: The Middle Ages , the Islamic world adopted Hippocratic methods and developed new medical technologies. After the European Renaissance , Hippocratic methods were revived in western Europe and even further expanded in the 19th century. Notable among those who employed Hippocrates's rigorous clinical techniques were Thomas Sydenham , William Heberden , Jean-Martin Charcot and William Osler . Henri Huchard ,

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4494-705: The Saint Catherine's Monastery in South Sinai , they found a manuscript which contains a medical recipe of Hippocrates. The manuscript also contains three recipes with pictures of herbs that were created by an anonymous scribe. The Hippocratic Corpus (Latin: Corpus Hippocraticum ) is a collection of around seventy early medical works collected in Alexandrian Greece . It is written in Ionic Greek . The question of whether Hippocrates himself

4601-646: The Swiss National Science Foundation (SNSF) to develop evidence-based communication guidelines for disclosing medical errors to patients. In 2019, the Swiss Federal Office of Public Health tasked her to analyze the pandemic communication surrounding Covid-19. In 2016, Hannawa founded an interdisciplinary Center for the Advancement of Healthcare Quality and Safety (CAHQS) at the Università della Svizzera italiana. In

4708-503: The ahnentafel of Hippocrates II is: 1. Hippocrates II. 2. Heraclides 4. Hippocrates I. 8. Gnosidicus 16. Nebrus 32. Sostratus III. 64. Theodorus II. 128. Sostratus, II. 256. Thedorus 512. Cleomyttades 1024. Crisamis 2048. Dardanus 4096. Sostratus 8192. Hippolochus 16384. Podalirius 32768. Asklepius Annegret Hannawa Annegret Friederike Hannawa (born 27 April 1979 in Konstanz , Germany )

4815-492: The AHRQ quality measure modules; based on expert input, risk adjustment, and other considerations. Thirteen inpatient indicators are recommended for use at the hospital level, and five are designated area indicators. Inpatient indicators are treatments or conditions with the greatest potential of an adverse event for hospitalized children. Possible additions to the dataset will address the patient's condition on admission and increase

4922-504: The Corpus. Among the treatises of the Corpus are The Hippocratic Oath ; The Book of Prognostics ; On Regimen in Acute Diseases ; Aphorisms ; On Airs, Waters and Places ; Instruments of Reduction ; On The Sacred Disease ; etc. The Hippocratic Oath, a seminal document on the ethics of medical practice, was attributed to Hippocrates in antiquity although new information shows it may have been written after his death. This

5029-612: The Faculty of Communication, Università della Svizzera italiana (USI, Lugano, Switzerland), where she still works today. Hannawa conducted a grant-funded international congress entitled "Communicating Medical Error (COME)" in 2013. The conference evolved into the nonprofit organization "ISCOME Global Center for the Advancement of Communication Science in Healthcare." To date, Hannawa leads this research association as its founding president-elect. Also in 2013, she received funding from

5136-551: The United States, anesthesiology became the leading medical specialty addressing issues of patient safety. Likewise in Australia, the Australian Patient Safety Foundation was founded in 1989 for anesthesia error monitoring. Both organizations were soon expanded as the magnitude of the medical error crisis became known. In the United States, the full magnitude and impact of errors in health care

5243-493: The United States, due to concern with interoperability and compliance with future national standards. Such concerns are not inconsequential; standards for electronic prescribing for Medicare Part D conflict with regulations in many US states. A standardized, modular technology system that allows a hospital, clinic, or health system record their Incidents that include falls, medication errors, pressure ulcers, near misses, etc. These systems can be configured to specific workflows and

5350-483: The age of 83, 85 or 90, though some say he lived to be well over 100. It is thus with regard to the disease called Sacred : it appears to me to be nowise more divine nor more sacred than other diseases, but has a natural cause from the originates like other affections. Men regard its nature and cause as divine from ignorance and wonder... Hippocrates is credited as the first person to believe that diseases were caused naturally, not because of superstition and gods. He

5457-420: The ailments of the human rectum and the treatment thereof, despite the school's poor theory of medicine. Hemorrhoids , for instance, though believed to be caused by an excess of bile and phlegm, were treated by Hippocratic physicians in relatively advanced ways. Cautery and excision are described in the Hippocratic Corpus, in addition to the preferred methods: ligating the hemorrhoids and drying them with

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5564-401: The analytics behind it will allow for reporting and dashboards to help learn from things that have gone wrong (and right). Some vendors include Datix, RL Solutions, Verge, Midas, and Quantros. Technology induced errors are significant and increasingly more evident in care delivery systems. This idiosyncratic and potentially serious problems associated with HIT implementation has recently become

5671-619: The best thing that physicians could do was to evaluate an illness and predict its likely progression based upon data collected in detailed case histories. Hippocratic medicine was notable for its strict professionalism, discipline, and rigorous practice. The Hippocratic work On the Physician recommends that physicians always be well-kempt, honest, calm, understanding, and serious. The Hippocratic physician paid careful attention to all aspects of his practice: he followed detailed specifications for "lighting, personnel, instruments, positioning of

5778-494: The body contains within itself the power to re-balance the four humours and heal itself ( physis ). Hippocratic therapy focused on simply easing this natural process. To this end, Hippocrates believed "rest and immobilization [were] of capital importance". In general, the Hippocratic medicine was very kind to the patient; treatment was gentle, and emphasized keeping the patient clean and sterile. For example, only clean water or wine were ever used on wounds, though "dry" treatment

5885-513: The earliest recorded reference to endoscopy . Hippocrates often used lifestyle modifications such as diet and exercise to treat diseases such as diabetes , what is today called lifestyle medicine . Two popular but likely misquoted attributions to Hippocrates are "Let food be your medicine, and medicine be your food" and "Walking is man's best medicine". Both appear to be misquotations, and their exact origins remain unknown. In 2017, researchers claimed that, while conducting restorations on

5992-445: The edge. This situation is not ideal for people to feel, especially not people who have to look after patients and take care of others who can be in very severe states. Using what Freudenberger described, there was a scale created to measure the amount of burnout in the healthcare field. Known as Maslach's scale, this measures 1) Workload 2) Control 3) Reward 4) Community 5) Fairness and 6) Values. All of these core points work together and

6099-409: The exemplar of that flexible, critical, well-poised attitude of mind, ever on the lookout for sources of error, which is the very essence of the scientific spirit." "His figure... stands for all time as that of the ideal physician," according to A Short History of Medicine , inspiring the medical profession since his death. The Travels of Sir John Mandeville reports (incorrectly) that Hippocrates

6206-672: The face muscles may also be termed the Hippocratic Smile. The most severe form of hair loss and baldness is called the Hippocratic form. In the modern age, a lunar crater has been named Hippocrates . The Hippocratic Museum , a museum on the Greek island of Kos is dedicated to him. The Hippocrates Project is a program of the New York University Medical Center to enhance education through use of technology. Project Hippocrates (an acronym of "High Performance Computing for Robot-Assisted Surgery")

6313-533: The findings could generate large-scale intervention studies conducted with a faster life cycle. The Agency for Healthcare Research and Quality (AHRQ) is the Federal authority for patient safety and quality of care and has been a leader in pediatric quality and safety. AHRQ has developed Pediatric Quality Indicators (PedQIs) with the goal to highlight areas of quality concern and to target areas for further analysis. Eighteen pediatric quality indicators are included in

6420-804: The fingers, an important diagnostic sign in chronic lung disease, lung cancer and cyanotic heart disease . For this reason, clubbed fingers are sometimes referred to as "Hippocratic fingers". Hippocrates was also the first physician to describe Hippocratic face in Prognosis . Shakespeare famously alludes to this description when writing of Falstaff 's death in Act II, Scene iii. of Henry V . Hippocrates began to categorize illnesses as acute , chronic , endemic and epidemic , and use terms such as, "exacerbation, relapse , resolution, crisis, paroxysm , peak, and convalescence ." Another of Hippocrates's major contributions may be found in his descriptions of

6527-606: The government or the Swiss Canton of Uri recognized her with an appointment as Ambassador. In June 2024, she founded the European Institute for Safe Communication (EISK), bringing together science and practice to protect professionals in aviation, healthcare, emergency services, energy, and crisis management from communication failures in high-risk situations. Hannawa's research focuses primarily on how "safe communication" can prevent harmful errors in everyday clinical practice and ensure high-quality healthcare, particularly in

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6634-421: The hideous dragon; they die soon thereafter. This is a version of the legend of Melusine . Some clinical symptoms and signs have been named after Hippocrates as he is believed to be the first person to describe them. Hippocratic face is the change produced in the countenance by death, or long sickness, excessive evacuations, excessive hunger, and the like. Clubbing , a deformity of the fingers and fingernails,

6741-544: The hospital. Burnout has been going on for years amongst nurses and other physicians, affecting nearly half of healthcare workers. Burnout has been going on for decades and the term was originally coined by Herbert Freudenberger who was working at a free clinic and overtime he mentioned some of the effects that he had seen, "emotional depletion and accompanying psychosomatic symptoms...excessive demands on energy, strength, or resources". These symptoms are commonly seen today in hospital settings as nurses feel like they are pushed to

6848-563: The incident. In Canada, a quality improvement review is primarily used. A quality improvement review is an evaluation that is completed after an adverse event occurs with the intention to both fix the problem, as well as preventing it from happening again. The individual provinces and territories have laws on whether it is required to disclose the quality improvement review to the patient. Healthcare providers have an obligation to disclose any adverse event to their patients because of ethical and professional guidelines. If more providers participate in

6955-599: The increased stresses caused by the diffusion of new technology, unfamiliar and new process errors often result. If not recognized, over time these new errors can collectively lead to catastrophic system failures. The term "e-iatrogenesis" can be used to describe the local error manifestation. The sources for these errors include: Solutions include ongoing changes in design to cope with unique medical settings, supervising overrides from automatic systems, and training (and re-training) all users. Evidence-based medicine integrates an individual doctor's exam and diagnostic skills for

7062-644: The introduction of new and previously unseen error types. Handwritten reports or notes, manual order entry, non-standard abbreviations and poor legibility lead to substantial errors and injuries, according to the IOM (2000) report. The follow-up IOM report, Crossing the Quality Chasm: A New Health System for the 21st Century , advised rapid adoption of electronic patient records, electronic medication ordering, with computer- and internet-based information systems to support clinical decisions. This section contains only

7169-798: The largest identified source of preventable errors in hospitals (IOM, 2000; 2007). The IOM (2006) estimates that each hospitalized patient, on average, is exposed to one medication error each day. Computerized provider order entry (CPOE), formerly called computerized physician order entry , can reduce medication errors by 80% overall but more importantly decrease harm to patients by 55%. A Leapfrog (2004) survey found that 16% of US clinics, hospitals, and medical practices are expected to utilize CPOE within 2 years. A standardized bar code system for dispensing drugs might prevent 25% of drug errors. Despite ample evidence to reduce medication errors, compete medication delivery systems (barcoding and Electronic prescribing ) have slow adoption by doctors and hospitals in

7276-440: The last several years, pediatric groups have partnered to improve general understanding, reporting, process improvement methodologies, and quality of pediatric inpatient care. These collaborations have created a robust program of projects, benchmarking efforts, and research. Much of the research and focus on adverse events has been on medication errors–the most frequently reported adverse event for both adult and pediatric patients. It

7383-609: The less you have of them the more likely that burnout will occur and cause a major decrease in patient safety. Similarly to Maslach's scale, there is the Conservation of Resources Theory which essentially states that if one of the four pillars are lost, so is safety and control, "Healthcare organizations and nursing administration should develop strategies to protect nurses from the threat of resource loss to decrease nurse burnout, which may improve nurse and patient safety." The amount of nursing professionals that have experienced burnout

7490-503: The limited number of federal and state regulations that exist and in the absence of national accreditation organizations such as the Joint Commission - a driving force for performance improvement in health care systems. Community pharmacies are using automated drug dispensing devices (robots), computerized drug utilization review tools, and most recently, the ability to receive electronic prescriptions from prescribers to decrease

7597-476: The medical field, 1 out of 20 prescriptions filled contains an error, considering the billions of prescriptions that get filled ever year there is an insane amount of error happening. And with these errors not only is there a likelihood of a prescription being wrong but there is a $ 3.5 billion price-tag that goes with that covering the amount that people pay each year for litigation costs and extra days that patients need to stay in hospital beds because of mistakes from

7704-428: The number of nurses providing patient care is recognized as an inadequate measure of nursing care quality, there is hard evidence that nurse staffing is directly related to patient outcomes. Studies by Aiken and Needleman have demonstrated that patient death, nosocomial infections, cardiac arrest, and pressure ulcers are linked to inadequate nurse-to-patient ratios. The presence or absence of registered nurses (RNs) impacts

7811-525: The opposite effect as it can lead to severe patient harm. Communication with regards to patient safety can be classified into two categories: prevention of adverse events and responding to adverse events. Use of effective communication can aid in the prevention of adverse events, whereas ineffective communication can contribute to these incidences. If ineffective communication contributes to an adverse event, then better and more effective communication skills must be applied in response to achieve optimal outcomes for

7918-472: The outcome for pediatric patients requiring pain management and/or peripheral administration of intravenous fluids and/or medications. These two indicators of pediatric nursing care quality are sensitive measures of nursing care. Professional nurses play a key role in successful pain management, especially among pediatric patients unable to verbally describe pain. Astute assessment skills are required to intervene successfully and relieve discomfort.33 Maintenance of

8025-523: The past few years. In the United States, over 1,700 guidelines (see example image, right) have been developed as a resource for physicians to apply to specific patient presentations. The National Institute for Health and Clinical Excellence (NICE) in the United Kingdom provides detailed "clinical guidance" for both health care professionals and the public about specific medical conditions. National Guideline Agencies from all continents collaborate in

8132-603: The patient details provided in different situations are always reliable. These systems offer three differently qualified options: Any of these options may be applied whenever and wherever patient details are required in electronic form Such identifying is essential when the information concerned is critical. There are increasing numbers of hospitals that have an RFID system to identify patients, for instance: Hospital La Fe in Valencia(Spain) ; Wayne Memorial Hospital (US); Royal Alexandria Hospital (UK). Prescribing errors are

8239-497: The patient in the most convenient form possible. Communication between healthcare professionals not only helps achieve the best results for the patient but also prevents any unseen incidents. As is the case in other industries, when there is a mistake or error made people look for someone to blame. This may seem natural, but it creates a blame culture where who is more important than why or how . A just culture , also sometimes known as no blame or no fault , seeks to understand

8346-473: The patient safety related aspects of HIT. The electronic health record (EHR), previously known as the electronic medical record (EMR), reduces several types of errors, including those related to prescription drugs, to emergency and preventive care, and to tests and procedures. Important features of modern EHR include automated drug-drug/drug-food interaction checks and allergy checks, standard drug dosages and patient education information. Drug Information at

8453-410: The patient's condition, and poor leadership or training. Common misconceptions about adverse events are: In the medical field there are many things that can lead to a decrease of patient safety. One big influence on this is nurse burnout, leading to hundreds of thousands of deaths a year, to billions of dollars spent when having to rectify a new problem, this is a real issue in the world. On average in

8560-409: The patient's safety. There are different modes in which healthcare professionals can work to optimize the safety of patients which include both verbal and nonverbal communication, as well as the effective use of appropriate communication technologies. Methods of effective verbal and nonverbal communication include treating patients with respect and showing empathy, clearly communicating with patients in

8667-576: The patient, and techniques of bandaging and splinting" in the ancient operating room . He even kept his fingernails to a precise length. The Hippocratic school gave importance to the clinical doctrines of observation and documentation. These doctrines dictate that physicians record their findings and their medicinal methods in a very clear and objective manner, so that these records may be passed down and employed by other physicians. Hippocrates made careful, regular note of many symptoms including complexion, pulse, fever, pains, movement, and excretions. He

8774-521: The physician of experience and common sense." His image as the wise, old doctor is reinforced by busts of him, which wear large beards on a wrinkled face. Many physicians of the time wore their hair in the style of Jove and Asklepius . Accordingly, the busts of Hippocrates that have been found could be only altered versions of portraits of these deities. Hippocrates and the beliefs that he embodied are considered medical ideals. Fielding Garrison , an authority on medical history, stated, "He is, above all,

8881-513: The point-of-care and drug dispensing points help in reducing errors. Example: India, MedCLIK. Also, these systems provide recurring alerts to remind clinicians of intervals for preventive care and to track referrals and test results. Clinical guidelines for disease management have a demonstrated benefit when accessible within the electronic record during the process of treating the patient. Advances in health informatics and widespread adoption of interoperable electronic health records promise access to

8988-452: The quality improvement review, it can increase interdisciplinary collaboration and can sustain relationships between departments and staff. In the US, clinical peer review is used: uninvolved medical staff review the event and work toward preventing further incidents. The disclosure of adverse events is important in maintaining trust in the relationship between healthcare provider and patient. It

9095-448: The quality of their pharmaceutical care outcomes and pharmacy services. New technologies facilitate the traceability tools of patients and medications. This is particularly relevant for drugs that are considered high risk and cost. Quality improvement and patient safety is a major concern in the pediatric world of health care. This next section will focus on quality improvement and patient safety initiatives in inpatient settings. Over

9202-508: The reduction of administrative burden, releasing the operating staff and easing the operational demand by model driven orders, thus enabling adherence to a well executable procedure finalized with a qualified minimum of required feedback. The use of effective communication among patients and healthcare professionals is critical for achieving a patient's optimal health outcome. However, scientific patient safety research by Annegret Hannawa , among others, has shown that ineffective communication has

9309-470: The risk for error and increase the likelihood of delivering high quality of care. Quality Assurance (QA) in community practice is a relatively new concept. As of 2006, only 16 states have some form of legislation that regulates QA in community pharmacy practice. While most state QA legislation focuses on error reduction, North Carolina has recently approved legislation that requires the pharmacy QA program to include error reduction strategies and assessments of

9416-419: The root causes of an incident rather than just who was involved. In health care, there is a move towards a patient safety culture. This applies the lessons learned from other industries, such as aviation , marine , and industrial , to a health care setting. When assessing and analyzing an incident, individuals involved are much more likely to be forthcoming with their own mistakes if they know that their job

9523-606: The same year, she was elected as a scientific expert to the ELSI Advisory Board of the Swiss Personalized Health Network (SPHN). In addition, she received honorary titles as Associate Faculty at Johns Hopkins University Bloomberg School of Public Health ( Baltimore , Maryland , USA) and Cardiff University School of Medicine ( Wales , United Kingdom). In the same year, she was awarded the " Jozien Bensing Research Award". In 2023,

9630-413: The school of medicine named after him, nor wrote most of the treatises attributed to him, he is traditionally regarded as the "Father of Medicine". His contributions revolutionized the practice of medicine; but after his death the advancement stalled. So revered was Hippocrates that his teachings were largely taken as too great to be improved upon and no significant advancements of his methods were made for

9737-399: The situation). It is also the responsibility of the provider to know the advantages and limitations of using electronic health records , as they do not convey all information necessary to understanding patient needs. If a health care professional is not practicing these skills, they are not being an effective communicator which may affect patient outcome. The goal of a healthcare professional

9844-425: The staggering statistics: from 44,000 to 98,000 preventable deaths annually due to medical error in hospitals, 7,000 preventable deaths related to medication errors alone. Within 2 weeks of the report's release, Congress began hearings and President Clinton ordered a government-wide study of the feasibility of implementing the report's recommendations. Initial criticisms of the methodology in the IOM estimates focused on

9951-416: The statistical methods of amplifying low numbers of incidents in the pilot studies to the general population. However, subsequent reports emphasized the striking prevalence and consequences of medical error. The experience has been similar in other countries. Building a culture for patient safety requires psychologically safe teams. Psychological safety is an interpersonal construct which is experienced at

10058-468: The symptomatology, physical findings, surgical treatment and prognosis of thoracic empyema , i.e. suppuration of the lining of the chest cavity. His teachings remain relevant to present-day students of pulmonary medicine and surgery. Hippocrates was the first documented chest surgeon and his findings and techniques, while crude, such as the use of lead pipes to drain chest wall abscess, are still valid. The Hippocratic school of medicine described well

10165-460: The team or group level. It is an environment where people feel comfortable sharing concerns and mistakes without fear of embarrassment or retribution. This safe environment enables not just speaking up , which is clearly relevant to patient safety, but also to share new ideas and give candid feed back. Through this process, a broader variety of information is shared in the organisation, allowing for creativity, innovation and learning, but also providing

10272-484: The understanding of how laboratory and pharmacy utilization impact patient outcomes. The goal of AHRQ is to refine the area-level indicators to improve outcomes for children receiving outpatient care and reduce the incidence of hospitalization for those defined conditions. Numerous groups are engaged in improving pediatric care, quality and safety. Each of these groups has a unique mission and membership. The following table details these groups' missions and websites. While

10379-525: Was a Greek physician and philosopher of the classical period who is considered one of the most outstanding figures in the history of medicine . He is traditionally referred to as the "Father of Medicine" in recognition of his lasting contributions to the field, such as the use of prognosis and clinical observation, the systematic categorization of diseases, and the (however misguided) formulation of humoral theory . The Hippocratic school of medicine revolutionized ancient Greek medicine , establishing it as

10486-410: Was a disease in and of itself. Hippocrates treated patients with fever by starving them out, believing that 'starving' the fever was a way to neutralize the disease. He may therefore have been the originator of the idea " Feed a cold, starve a fever ". One of the strengths of Hippocratic medicine was its emphasis on prognosis . At Hippocrates's time, medicinal therapy was quite immature, and often

10593-573: Was acknowledged by the disciples of Pythagoras for allying philosophy and medicine. He separated the discipline of medicine from religion, believing and arguing that disease was not a punishment inflicted by the gods but rather the product of environmental factors , diet, and living habits. There is not a single mention of a mystical illness in the entirety of the Hippocratic Corpus. However, Hippocrates did hold many convictions that were based on incorrect anatomy and physiology , such as Humorism . Ancient Greek schools of medicine were split into

10700-476: Was born around the year 460 BC on the Greek island of Kos ; other biographical information, however, is likely to be untrue. Soranus of Ephesus , a 2nd-century Greek physician , was Hippocrates's first biographer and is the source of most personal information about him. Later biographies are in the Suda of the 10th century AD, and in the works of John Tzetzes , which date from the 12th century AD. Hippocrates

10807-685: Was brought to medical errors in 1999 when the Institute of Medicine reported that about 98,000 deaths occur every year due to medical errors made in hospitals. By 1984 the American Society of Anesthesiologists (ASA) had established the Anesthesia Patient Safety Foundation(APSF). The APSF marked the first use of the term "patient safety" in the name of professional reviewing organization. Although anesthesiologists comprise only about 5% of physicians in

10914-697: Was not appreciated until the 1990s, when several reports brought attention to this issue. In 1999, the Institute of Medicine (IOM) of the National Academy of Sciences released a report, To Err is Human : Building a Safer Health System . The IOM called for a broad national effort to include establishment of a Center for Patient Safety, expanded reporting of adverse events, development of safety programs in health care organizations, and attention by regulators, health care purchasers, and professional societies. The majority of media attention, however, focused on

11021-536: Was on patient care and prognosis , not diagnosis. It could effectively treat diseases and allowed for a great development in clinical practice. Hippocratic medicine and its philosophy are far removed from modern medicine, in which the physician focuses on specific diagnosis and specialized treatment, both of which were espoused by the Knidian school. This shift in medical thought since Hippocrates's day has generated serious criticism of their denunciations; for example,

11128-403: Was preferable. Soothing balms were sometimes employed. Hippocrates was reluctant to administer drugs and engage in specialized treatment that might prove to be wrongly chosen; generalized therapy followed a generalized diagnosis. Some of the generalized treatments he prescribed are fasting and the consumption of a mix of honey and vinegar. Hippocrates once said that "to eat when you are sick,

11235-403: Was that of a crisis , a point in the progression of disease at which either the illness would begin to triumph and the patient would succumb to death, or the opposite would occur and natural processes would make the patient recover. After a crisis, a relapse might follow, and then another deciding crisis. According to this doctrine, crises tend to occur on critical days , which were supposed to be

11342-511: Was the author of any of the treatises in the corpus has not been conclusively answered, but modern debate revolves around only a few of the treatises seen as potentially authored by him. Because of the variety of subjects, writing styles and apparent date of construction, the Hippocratic Corpus could not have been written by one person (Ermerins numbers the authors at nineteen). The corpus came to be known by his name because of his fame; possibly all medical works were classified under 'Hippocrates' by

11449-431: Was the ruler of the islands of "Kos and Lango" [sic], and recounts a legend about Hippocrates's daughter. She was transformed into a hundred-foot long dragon by the goddess Diana , and is the "lady of the manor" of an old castle. She emerges three times a year, and will be turned back into a woman if a knight kisses her, making the knight into her consort and ruler of the islands. Various knights try, but flee when they see

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