Flashcards in Making Mistakes Deck (14):
Why is medicine a difficult environment in which to report or admit errors?
-70% doctors said they received no or little support from their organisation when something went wrong
-49% fear of consequences is why whistleblowing is ineffective
-60% not even consider whistleblowing because of the doubts of the process
-18% who blew the whistle felt isolated
-just less than 40% of doctors who raised concerns felt they had been addressed
What are the common causes of basic-error making in clinical practice?
-covering for colleagues
-feeling that decisions must be made alone
-unable to admit to uncertainty
What is a person-centred approach in terms of dealing with medical errors?
focused on dealing with the individual doctor
What is a system-based approach to dealing with medical errors?
considers the environment and seeks to minimise opportunities for error
Give an example of a person centred approach.
individual doctors have to just accept responsibility where it falls to them, just as they accept the accolades . People run systems, they do not run themselves.
give an example of a systems based approach.
human error is anticipated and there are non-punitive reporting systems. Produce an organisation with a memory.
What are ways of reducing error through a systems based approach?
-dedicated centres, beneficial for less common and uncommon procedures
-requirement to retrain, new procedures and new techniques
-data collection of incidents
-improved instrument design
-protocols and guidelines
what is the duty of candour? which was introduced in the 2015 health bill
A legal requirement for for health and social care organisations to inform people when they have been harmed are a result of the care or treatment they have received
What are the four steps involved in the professional duty of candour?
-tell the patient (advocate, family member) when something has gone wrong
-apologising to the patient
-offer an appropriate remedy or support to put matters right
-explain full to the patient the short and long term effects of what has happened
What are the three elements which comprise action in negligence?
-he/she is owed a duty of care by the defendant
-that the defendant breached that duty by failing to provide reasonable care
-that the breach of duty caused the claimant those injuries and that those injuries are not too remote
Explain the Bolam test 1957.
a doctor is not guilty of negligence if he has acted in accordance with a practice accepted as proper by a responsible body of medical men skilled in that art
what is the Bolitho amendment 1997?
added to Bolam: the professional opinion must be capable of withstanding logical analysis
The impact of Montgomery. What 3 questions which should be addressed when dealing with consent?
-Does the patient know about the material risks of the treatment I am proposing?
-does the patient know of the alternatives to this treatment?
-Have I taken responsible care to ensure the patient actually knows this?