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First do no harm: practitioners’ ability to ‘diagnose’ system weaknesses and improve safety is a critical initial step in improving care quality

Healthcare systems across the world and especially those in low-resource settings (LRS) are under pressure and one of the first priorities must be to prevent any harm done while trying to deliver care. Health care workers, especially department leaders, need the diagnostic abilities to identify loca...

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Autores principales: English, Mike, Ogola, Muthoni, Aluvaala, Jalemba, Gicheha, Edith, Irimu, Grace, McKnight, Jacob, Vincent, Charles A
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7982941/
https://www.ncbi.nlm.nih.gov/pubmed/33361068
http://dx.doi.org/10.1136/archdischild-2020-320630
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author English, Mike
Ogola, Muthoni
Aluvaala, Jalemba
Gicheha, Edith
Irimu, Grace
McKnight, Jacob
Vincent, Charles A
author_facet English, Mike
Ogola, Muthoni
Aluvaala, Jalemba
Gicheha, Edith
Irimu, Grace
McKnight, Jacob
Vincent, Charles A
author_sort English, Mike
collection PubMed
description Healthcare systems across the world and especially those in low-resource settings (LRS) are under pressure and one of the first priorities must be to prevent any harm done while trying to deliver care. Health care workers, especially department leaders, need the diagnostic abilities to identify local safety concerns and design actions that benefit their patients. We draw on concepts from the safety sciences that are less well-known than mainstream quality improvement techniques in LRS. We use these to illustrate how to analyse the complex interactions between resources and tools, the organisation of tasks and the norms that may govern behaviours, together with the strengths and vulnerabilities of systems. All interact to influence care and outcomes. To employ these techniques leaders will need to focus on the best attainable standards of care, build trust and shift away from the blame culture that undermines improvement. Health worker education should include development of the technical and relational skills needed to perform these system diagnostic roles. Some safety challenges need leadership from professional associations to provide important resources, peer support and mentorship to sustain safety work.
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spelling pubmed-79829412021-03-30 First do no harm: practitioners’ ability to ‘diagnose’ system weaknesses and improve safety is a critical initial step in improving care quality English, Mike Ogola, Muthoni Aluvaala, Jalemba Gicheha, Edith Irimu, Grace McKnight, Jacob Vincent, Charles A Arch Dis Child Global Child Health Healthcare systems across the world and especially those in low-resource settings (LRS) are under pressure and one of the first priorities must be to prevent any harm done while trying to deliver care. Health care workers, especially department leaders, need the diagnostic abilities to identify local safety concerns and design actions that benefit their patients. We draw on concepts from the safety sciences that are less well-known than mainstream quality improvement techniques in LRS. We use these to illustrate how to analyse the complex interactions between resources and tools, the organisation of tasks and the norms that may govern behaviours, together with the strengths and vulnerabilities of systems. All interact to influence care and outcomes. To employ these techniques leaders will need to focus on the best attainable standards of care, build trust and shift away from the blame culture that undermines improvement. Health worker education should include development of the technical and relational skills needed to perform these system diagnostic roles. Some safety challenges need leadership from professional associations to provide important resources, peer support and mentorship to sustain safety work. BMJ Publishing Group 2021-04 2020-12-23 /pmc/articles/PMC7982941/ /pubmed/33361068 http://dx.doi.org/10.1136/archdischild-2020-320630 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/ https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Global Child Health
English, Mike
Ogola, Muthoni
Aluvaala, Jalemba
Gicheha, Edith
Irimu, Grace
McKnight, Jacob
Vincent, Charles A
First do no harm: practitioners’ ability to ‘diagnose’ system weaknesses and improve safety is a critical initial step in improving care quality
title First do no harm: practitioners’ ability to ‘diagnose’ system weaknesses and improve safety is a critical initial step in improving care quality
title_full First do no harm: practitioners’ ability to ‘diagnose’ system weaknesses and improve safety is a critical initial step in improving care quality
title_fullStr First do no harm: practitioners’ ability to ‘diagnose’ system weaknesses and improve safety is a critical initial step in improving care quality
title_full_unstemmed First do no harm: practitioners’ ability to ‘diagnose’ system weaknesses and improve safety is a critical initial step in improving care quality
title_short First do no harm: practitioners’ ability to ‘diagnose’ system weaknesses and improve safety is a critical initial step in improving care quality
title_sort first do no harm: practitioners’ ability to ‘diagnose’ system weaknesses and improve safety is a critical initial step in improving care quality
topic Global Child Health
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7982941/
https://www.ncbi.nlm.nih.gov/pubmed/33361068
http://dx.doi.org/10.1136/archdischild-2020-320630
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