Structural Approaches to Address Issues in Patient Safety

This volume explores the ways in which structural changes in health care environments impact patient safety. It delves into the potential that design thinking can have when applied to organizational systems and structures, as well as the physical environment, to mitigate risks, reduce medical errors and ultimately improve the quality of care, provider well-being, and the overall patient experience. Much of health management empirical research has focused on the process and outcomes and then attempted to reverse engineer the structure that may reasonably explain that. This volume presents studies from the United States and Europe to demonstrate the benefits of a structure led approach. The chapters employ a variety of methods including needs assessment, consensus building, systems modelling, survey research, secondary analysis of EMR data, and qualitative methodologies. Together they provide meaningful conclusions to the question of how structural approaches in learning health care environments can be improved to create a positive impact on patient safety.

This volume consists of 12 essays on structural approaches to issues of patient safety. Medical, management, and other specialists from the US and Europe address systems-based improvements that target hospital design; guiding change in the healthcare environment using a flexible process model; using a systems modeling approach to reduce the risk of healthcare-associated infections; the role of geographic information systems for infection control in hospitals; the use of human factor approaches to develop and conduct an evaluation of the design of a neonatal intensive care unit; the role of burnout in the relationship between a perceived patient-safe, friendly working environment and unsafe performance in an obstetric unit; failure-to-rescue event mitigation system assessment; continuous cardiac monitoring policy implementation; sterile processing of instruments and the preparation of case carts; cultivating a culture of continuous learning and improvement; a systems approach to the design and implementation of patient assessment tools in the inpatient setting; and optimizing the patient experience.

Susan D. Moffatt-Bruce is the Executive Director of University Hospital at The Ohio State University Wexner Medical Center. She is a Professor of Surgery and Biomedical Informatics as well as a practicing Cardiothoracic Surgeon.