Establishing a Culture of Patient Safety

Joseph F. Pauley, Judith Ann Pauley

Description

The purpose of this book is to provide a road map to help healthcare professionals establish a “culture of patient safety” in their facilities and practices, provide high quality healthcare, and increase patient and staff satisfaction by improving communication among staff members and between medical staff and patients. It achieves this by describing what each of six types of people will do in distress, by providing strategies that will allow healthcare professionals to deal more effectively with staff members and patients in distress, and by showing healthcare professionals how to keep themselves out of distress by getting their motivational needs met positively every day.
The concepts described in this book are scientifically based and have withstood more than 40 years of scrutiny and scientific inquiry. They were first used as a clinical model to help patients help themselves, and indeed are still used clinically. The originator of the concepts, Dr. Taibi Kahler, is an internationally recognized clinical psychologist who was awarded the 1977 Eric Berne Memorial Scientific Award for the clinical application of a discovery he made in 1971. That discovery enabled clinicians to shorten significantly the treatment time of patients by reducing their resistance as a result of miscommunication between their doctors and themselves.

Sujets

• Business
• Qualité, hygiène, sécurité, environnement
• Total Quality Management
• Gestion et management
• Economics

Informations

• Publié par: ASQ Quality Press
• Date de parution: 07 avril 2011
• Nombre de lectures: 0
• EAN13: 9780873895125
• Langue: English

Extrait

Establishing a Culture of Patient Safety
Improving Communication, Building Relationships, and Using Quality Tools
Judith Ann Pauley and Joseph F. Pauley
ASQ Quality Press
Milwaukee, Wisconsin
American Society for Quality, Quality Press, Milwaukee 53203
© 2012 by Judith Ann Pauley and Joseph F. Pauley
All rights reserved.
Library of Congress Cataloging-in-Publication Data
Pauley, Judith A.
Establishing a culture of patient safety : improving communication, building
relationships, and using quality tools / Judith Ann Pauley and Joseph F. Pauley.
p. cm.
Includes bibliographical references and index.
ISBN 978-0-87389-819-5 (alk. paper)
1. Hospitals—Administration. 2. Medical errors—Prevention. 3. Communication
in medicine. 4. Physician and patient. 5. Medical care—Safety measures. I. Pauley, Joseph F. II. Title.
[DNLM: 1. Hospital Administration. 2. Medical Errors—prevention & control.
3. Comprehensive Health Care—methods. 4. Models, Organizational. 5. Professional- Patient Relations. 6. Safety Management. WX 153]
RA971.P38 2011
362.11068—dc23
2011017946
No part of this book may be reproduced in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher.
Publisher: William A. Tony
Acquisitions Editor: Matt Meinholz
Project Editor: Paul O’Mara
Production Administrator: Randall Benson
ASQ Mission: The American Society for Quality advances individual, organizational, and community excellence worldwide through learning, quality improvement, and knowledge exchange.
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To
Major General (ret.) Gale S. Pollock, former Acting Surgeon General of the United States Army, for her friendship, for sharing her leadership skills with us, and for recognizing how the concepts of Process Communication can improve the healthcare provided to the army heroes wounded in battle defending our country and to their family members who have remained behind.
And to
Dr. Taibi Kahler, the clinical psychologist who made the discoveries on which the concepts of Process Communication are based, for his genius, for his friendship, and for improving our lives and the lives of all those we come in contact with every day.
And especially to
All the healthcare professionals who provide outstanding medical care to millions of patients every year, especially those who have dealt patiently with our idiosyncrasies and provided excellent medical care and advice to us throughout our lives.
Table of Contents
Foreword
Acknowledgments
Introduction
1 The Need to Improve Patient Safety
Three Examples
2 Who Are These People?
3 Interaction Styles
4 Perceptions
The Language of Perceptions
5 Channels of Communication
Establishing Contact
6 Motivational Needs
Motivating the Six Personality Types
Personality Phase
An Anesthetist’s Example
A Patient’s Example
7 Using the Concepts in Treating Patients
8 Distress
Workaholics
Persisters
Reactors
Dreamers
Rebels
Promoters
9 Healthcare Providers in Distress
Story One
Story Two
Story Three
Story Four
Story Five
Story Six
Story Seven
Story Eight
Story Nine
Story Ten
Story Eleven
Story Twelve
10 Getting Patients to Diet and Lead Healthy Lifestyles
11 Using the Concepts in Leading Improvement
Leading Improvement in a National Healthcare System
Leading Innovation in a Healthcare System Medical Education Department
Leading Improvement at a Medical Facility
Leading Improvement in a Family Clinic
Leading Improvement in a Healthcare System Education Institute
Leading Change to Develop a Team
Leading Change in a Women’s Hospital
Influencing Improvement in Safety Procedures in Biomedical Research Laboratories
Epilogue
Notes



Foreword
Human interaction can be complicated. It probably always has been. Even in the days when communities of our ancestors huddled together in caves for protection and for warmth, living together in proximity for extended periods, it was the same. As they negotiated or resolved to establish an agreed pecking order, and as they rationed out their (often scarce) resources, their skills in being able to relate effectively and constructively to one another were tested—and, indeed, the very survival of their community often depended on it. Not to mention the challenges of keeping their youngest ones safe, dealing with their impulsive and rebellious teenagers, and caring for their sick and elderly. All this required sophisticated social interaction. One would have to think that nothing has changed.
Well, almost nothing. The same bases for these intricacies of human behaviour remain. But what is different now is the environment in which they play out: It is much more complex and demanding. It places much greater stress on its inhabitants. The senses are bombarded with a greater range of stimuli that require rapid and specific responses. So in many ways, the range of skills required for effective daily functioning has become significantly more complex. It is not so much that the technology we use (whether it be cars or computers) has become more complicated, but more that the array of systems and processes with which we now have to comply has become increasingly complicated. Nowhere is this more evident than in the area of health services.
That is where this book comes in. It is true that the technology and techniques of medicine are advancing rapidly, concomitant with an ever-expanding knowledge base, and that this necessitates high levels of cognitive and technical expertise by those who provide medical care. Yet, this is not where the real challenge lies. Rather, it is that these advances also demand that all healthcare workers communicate effectively and work collaboratively, an absolute necessity if the complex processes that have been built up around healthcare provision are to function properly.
Why have these processes around the delivery of healthcare become so complex? Not surprisingly, there are several reasons. One obvious one is the explosion in knowledge and skills required within each specialty area. This has led to an increased level of specialization and delineation of the roles and responsibilities of each member of the workforce. In turn, this means that, more than ever before, health workers are dependent on those around them for support if they are to perform their work correctly.
But there is another reason, one that relates to patient safety. The public now expects good outcomes to be routine. Previously, complications were assumed mainly to be related to patient factors (e.g., old age, poor healing, comorbidity, or the patient not following the doctor’s instructions correctly) or to limitations in available technology. It was assumed that medical staff, being honest and having integrity, were infrequent contributors to poor outcomes. Now—and this book highlights the importance of this aspect—we realize that many, if not most, unexpected adverse events are due to human factors, specifically the actions and behaviour of those looking after the patients.
In short, medical error leads to adverse events, and adverse events lead to poor clinical outcomes. Understanding how medical error occurs is the first stage in reducing its incidence. This book reviews the evidence that certain types of human behaviour contribute to errors occurring. Moreover, it also shows the degree to which these types of behaviour are predictable. Fortunately, they can be recognized and dealt with, not only by health professionals reflecting on themselves but also by colleagues. Understanding the role of personality types and recognizing the effects of stress and distress allow a greater degree of collegiality and a more collaborative and supportive environment. The authors outline the tools available to achieve this. Put simply, once we have the tools that have been shown to improve behaviour (or eliminate those behaviours that contribute to mistakes), we will be on the road to providing a safer health system.
This book is a welcome addition to our libraries, as it applies the Process Communication Model ® to the health sector. We already know that human factors—primarily behaviour affected by varying degrees of stress—contribute to medical errors. Here we have a tome that reminds us that perhaps the most productive way to minimize medical error is to study how well-intentioned and committed health specialists function and communicate. Additionally, it encourages us to adopt some very specific tools to influence this behaviour in a way that eliminates many of the human factors that contribute to the high incidence of medical error that plagues our health services.
Spencer W. Beasley, MB, ChB (Otago), MS (Melbourne), F.R.A.C.S.
Professor of Paediatric Surgery, Christchurch School of Medicine and Health Sciences, University of Otago
Former Chair of the Board of Surgical Education and Training, Royal Australasian College of Surgeons
_______________________________
The healthcare industry today faces many challenges. In spite of the fact that technology has enabled healthcare professionals to provide the highest quality of healthcare in history, raise the life expectancy of our population, and find cures for illness after illness, we still are challenged to impro