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By Charles Vincent

The purpose of this publication is to lessen the hazards of scientific remedy and improve the protection of sufferers in all parts of healthcare. the 1st part discusses human errors, the occurrence of injury to sufferers, and the improvement or threat administration. Chapters within the moment part speak about the aid of danger in scientific perform in key clinical specialties. The 3rd part discusses good points of the healthcare structures which are necessary to secure perform, akin to communique of possibility to sufferers, the layout of kit, supervision and coaching, and powerful teamwork. The fourth part describes the right way to positioned threat administration into perform, together with the potent and delicate dealing with of proceedings and claims, the care of injured sufferers and the employees concerned, and the reporting, research and research of significant incidents.

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Preoperative assessment of patients with known or suspected coronary disease. N Engl J Med 1995;333:1750–6. 23 Mangano DT. Perioperative cardiac morbidity. Anesthesiology 1990;72:153–84. 24 Fleisher LA, Eagle KA. Screening for cardiac disease in patients having noncardiac surgery. Ann Intern Med 1996;124:767–72. 25 Lee TH, Marcantonio ER, Mangione CM, et al. Derivation and prospective validation of a simple index for prediction of cardiac risk of major noncardiac surgery. Circulation 1999;100:1043–9.

The goal of this chapter is to provide an overview of this diverse literature and an understanding of the importance of errors and adverse events. This is not a systematic review or meta-analysis and we do not attempt to mention every article or book written about this topic. Rather, we hope to convey the diversity of the methodological approaches to studying the epidemiology of this problem, and describe its impact and importance. 1 This chapter is divided into three sections. First we provide an overview of definitions and methodological issues related to the study of errors and adverse events.

5 Vincent C. Clinical risk management. London: BMJ Publications, 1995. 6 Hollnagel E. Reliability of cognition: foundations of human reliability analysis. London: Academic Press, 1993. 7 Gaba DM. Human error in anaesthetic mishaps. Int Anesth Clin 1989;27:137–47. 29 CLINICAL RISK MANAGEMENT 8 Runciman W, Sellen A, Webb RK, et al. Errors, incidents and accidents in anaesthetic practice. Anaesth Intensive Care 1993;21:506–19. 9 Reason J. Human error. New York: Cambridge University Press, 1990. 10 Sheen J.

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