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Patient Safety


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Table of Contents

Medical Competence and Patient Safety
Competence as Individual Virtue or Systems Issue?
Why the Difference in Competence Assumptions?
Good Doctoring and the Pursuit of Perfection
Standardization and the Fear of Scientific-Bureaucratic Medicine
The Expectation of Perfection versus the Inevitability of Mistake
Key Points

The Problem of "Human Error" in Healthcare
Numbers Are Strong
The Human Factors Approach
Human Error as Attribution and Starting Point
"I Knew This Could Happen!"
The Local Rationality Principle
Key Points

Cognitive Factors of Healthcare Work
Attentional Dynamics
Knowledge Factors
Strategic Factors
Key Points

New Technology, Automation, and Patient Safety
The Substitution Myth
Data Overload
Automation Surprises
Evaluating and Testing Medical Technology
Key Points

Safety Culture and Organizational Risk
Safety Culture and Drifting into Failure
Risk as Energy to Be Contained
Risk as Complexity
Risk as the Gradual Acceptance of the Abnormal
Risk as a Managerial or Control Problem
Key Points

Practical Tools for Creating Safety
Safety Reporting and Organizational Learning
Adverse Event Investigations
Human Factors and Resource Management Training
Briefings and Checklists
Key Points

Accountability and Learning from Failure
Learning and Accountability-Just Culture
Criminalization of Medical Error: A Growing Problem?
The Second Victim
Key Points

New Frontiers in Patient Safety: Complexity and Systems Thinking
Complicated versus Complex
Newton, Components, and Complexity
The Cartesian-Newtonian Worldview and Adverse Events
Key Points

About the Author

About the author: Sidney Dekker (PhD, The Ohio State University, 1996) is Professor and Director of the Key Centre for Ethics, Law, Justice and Governance at Griffith University, Brisbane, Australia. He was previously Professor and Director of the Leonardo da Vinci Center for Complexity and Systems Thinking at Lund University, Sweden, and Professor of Community Health Science at the Faculty of Medicine, University of Manitoba, Canada. He has been Visiting Professor at the Alfred Hospital in Melbourne, Australia. He recently became active as airline pilot, flying the Boeing 737.


"User-friendly and well written, this book takes the complex nature of healthcare seriously and pulls no punches. It demonstrates what the human factors approach can and does do, providing excellent examples to tease out the subtleties of this fascinating subject."
-The RoSPA Occupational Safety & Health Journal, June 2012

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