Patient Safety and Medical Errors: Building Safer Healthcare Systems for Better Care

Introduction

The adverse events in healthcare constitute a major issue of global interest since they could be traced in the healthcare systems of every country regardless of their level of development. Worldwide, millions of patients suffer or get injured and die annually due to the provision of unsafe care and treatment. Hospital infections, inadequate diagnosis, delays in treatment, adverse drug events and omissions of surgical procedures make up the most common root causes of medical errors or adverse events that may be avoided.

Donabedian (1980) suggested the evaluation of healthcare quality and linked it directly to the patient safety. Moreover, he suggested that the assessment of quality should be applied according to the structure (resources and administration), the process (culture and professional co-operation) and outcome (competence development and goal achievement). Twenty years after the Donabedian’s model, the managers of healthcare services adopted the principles of Total Quality Management (TQM) from Deming’s work. TQM promotes not only the team spirit and the coordination but also the clarification of the procedures, the commitment to the goals of the organization and the change, ultimately aiming at the constant pursuit and assurance of quality services. In healthcare, the Continuous Quality Improvement (CQI) has been considered as interdependent with the integrated implementation of a program which is based on a trustworthy risk management policy aimed at minimizing the chances of further instance of a preventable medical error (Donabedian, 1980). According to McFadden, Stock and Gowen (2014) although CQI initiatives are extremely associated with improved process quality, they are also connected with higher hospital-acquired condition rates, a measure of patient safety (McFadden, Stock, & Gowen, 2014).

Within the discussion framework about medical error prevention, European and non-European Organizations keep talking about methods and tools, which will effectively contribute to the assurance of a safe and high quality healthcare environment. According to Nix, Coopey and Clancy (2006) the quality tools include websites, protocols, data bases, newsletters, guidelines and other mechanisms in order to help healthcare professionals, legislators in the healthcare sector and patients to create, promote and cultivate quality conditions in healthcare organizations or in their daily lives. The significance of the above methods in CQI and patient safety is obvious (Nix, Coopey, & Clancy, 2006).

The main objectives of this chapter are first of all, the discription of “safety” as a parameter of healthcare quality as well as the categorization of concepts regarding the “patient safety”. Secondly, the clarification of the terms “patient safety culture” and “patient safety climate”, revealing the relation between them as well as the role of “patient safety culture” in the analysis of medical errors and adverse events and the presentation of the parameters linked to it. Finally, the authors give prominence to the importance of “safety culture” evaluation within the healthcare units and clearly present the methods of research for the evaluation of “Patient Safety Culture”, which are internationally used.

Background

Research by Cameron and Quain (2011) and Talbot (2008) argued that the term of “safety” is mentioned to the degree to which organizations provide the required responsibility to meet the demands of

• 1.

  The citizens’ satisfaction,

• 2.

  The justice in employment, and

• 3.

  The implementation of standards and controls, through bureaucratic procedures (Cameron & Quain, 2011; Talbot, 2008).