Abstract:
BACKGROUND:Every safety-critical industry devotes considerable time and resource to investigating and analysing accidents, incidents and near misses. The systematic analysis of incidents has greatly expanded our understanding of both the causes and prevention of harm. These methods have been widely employed in healthcare over the last 20 years but are now subject to critique and reassessment. In this paper, we reconsider the purpose and value of incident analysis and methods appropriate to the healthcare of today. MAIN TEXT:The primary need for a revised vision of incident analysis is that healthcare itself is changing dramatically. People are living longer, often with multiple co-morbidities which are managed over very long timescales. Our vision of safety analysis needs to expand concomitantly to embrace much longer timescales. Rather than think only in terms of the prevention of specific incidents, we need to consider the balance of benefit, harm and risks over long time periods encompassing the social and psychological impact of healthcare as well as physical effects. We argued for major changes in our approach to the analysis of safety events: assume that patients and families will be partners in investigation and where possible engage them fully from the beginning, examine much longer time periods and assess contributory factors at different time points in the patient journey, be more proportionate and strategic in analysing safety issues, seek to understand success and recovery as well as failure, consider the workability of clinical processes as well as deviations from them and develop a much more structured and wide-ranging approach to recommendations. CONCLUSIONS:Previous methods of incident analysis were simply adopted and disseminated with little research into the concepts, methods, reliability and outcomes of such analyses. There is a need for significant research and investment in the development of new methods. These changes are profound and will require major adjustments in both practical and cultural terms and research to explore and evaluate the most effective approaches.
journal_name
Implement Scijournal_title
Implementation science : ISauthors
Vincent C,Carthey J,Macrae C,Amalberti Rdoi
10.1186/s13012-017-0695-4subject
Has Abstractpub_date
2017-12-28 00:00:00pages
151issue
1issn
1748-5908pii
10.1186/s13012-017-0695-4journal_volume
12pub_type
杂志文章abstract:BACKGROUND:The use of opinion leaders is a strategy used to speed the process of translating research into practice. Much is still unknown about opinion leader attributes and activities and the context in which they are most effective. Agent-based modeling is a methodological tool that enables demonstration of the inte...
journal_title:Implementation science : IS
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journal_title:Implementation science : IS
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journal_title:Implementation science : IS
pub_type: 杂志文章
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journal_title:Implementation science : IS
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journal_title:Implementation science : IS
pub_type: 杂志文章,已发布勘误
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journal_title:Implementation science : IS
pub_type: 杂志文章
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journal_title:Implementation science : IS
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journal_title:Implementation science : IS
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journal_title:Implementation science : IS
pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章,随机对照试验
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journal_title:Implementation science : IS
pub_type: 杂志文章
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journal_title:Implementation science : IS
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journal_title:Implementation science : IS
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