Theories of Accident Causation Essay --

There is major concern about patient safety. It has been caused in part by obvious failures in which many patients have been harmed. This concern seems to be escalating worldwide. The medical culture that we’re in today seems to rely on secrecy, professional protection, defensiveness, and respect to authority. Theses ideologies are central to these failures, and preventing future failures depends on cultural as much as structural change in health care systems and organizations. Swiss Cheese Model James T. Reason developed the Swiss cheese model. The model is used in risk evaluations and risk management to determine accident causation. It’s an accident causation model used in aviation, engineering and healthcare. It represents the human systems used and equates them to Swiss cheese slices put side by side. Sometimes it is referred to as the cumulative act effect. The structure of the Swiss cheese model applies to most risky fields, but I will discuss how it applies to healthcare. The developer theorized that most accidents could be traced back to more than one failure. These failures include organizational influence, supervision, preconditions and specific acts. Some examples of preconditions include fatigued workers, or communication errors. Unsafe supervision can be explained as putting inexperienced nurses in an Oncology unit to administer chemotherapy. Organizational influences can be perceived as performing understaffed when the consequences are known. An organization’s guard against most failures, in the Swiss cheese model, are presented as a chain of walls, symbolized by the slices of cheese. The wholes that are in the cheese represent the weaknesses in individual parts of the healthcare system, and are constantly wavering i... ...ime or another, but if you can decrease that amount from what you normally see it could benefit your organizations reputation. Health care executives are able to better understand why keeping patients’ safe from harm protects market share, reimbursement levels, organizational reputation, and accreditation status (Carroll, 2009). Today, in almost every health care system, safety has become a top priority. Through patient safety efforts the risk management professionals can help to place trust back into the health care system. Reference Carroll, R. (2009). Risk Management Handbook for Health Care Organizations. San Fransisco, CA, USA: Jossey-Bass. Walshe, K., & Shortell, M. S. (2004, May). When Things Go Wrong: How Health Care Organizationa Deal With Failures. Retrieved January 15, 2014, from Health Affairs: content.healthaffairs.org/content/23/3/103.full Theories of Accident Causation Essay -- There is major concern about patient safety. It has been caused in part by obvious failures in which many patients have been harmed. This concern seems to be escalating worldwide. The medical culture that we’re in today seems to rely on secrecy, professional protection, defensiveness, and respect to authority. Theses ideologies are central to these failures, and preventing future failures depends on cultural as much as structural change in health care systems and organizations. Swiss Cheese Model James T. Reason developed the Swiss cheese model. The model is used in risk evaluations and risk management to determine accident causation. It’s an accident causation model used in aviation, engineering and healthcare. It represents the human systems used and equates them to Swiss cheese slices put side by side. Sometimes it is referred to as the cumulative act effect. The structure of the Swiss cheese model applies to most risky fields, but I will discuss how it applies to healthcare. The developer theorized that most accidents could be traced back to more than one failure. These failures include organizational influence, supervision, preconditions and specific acts. Some examples of preconditions include fatigued workers, or communication errors. Unsafe supervision can be explained as putting inexperienced nurses in an Oncology unit to administer chemotherapy. Organizational influences can be perceived as performing understaffed when the consequences are known. An organization’s guard against most failures, in the Swiss cheese model, are presented as a chain of walls, symbolized by the slices of cheese. The wholes that are in the cheese represent the weaknesses in individual parts of the healthcare system, and are constantly wavering i... ...ime or another, but if you can decrease that amount from what you normally see it could benefit your organizations reputation. Health care executives are able to better understand why keeping patients’ safe from harm protects market share, reimbursement levels, organizational reputation, and accreditation status (Carroll, 2009). Today, in almost every health care system, safety has become a top priority. Through patient safety efforts the risk management professionals can help to place trust back into the health care system. Reference Carroll, R. (2009). Risk Management Handbook for Health Care Organizations. San Fransisco, CA, USA: Jossey-Bass. Walshe, K., & Shortell, M. S. (2004, May). When Things Go Wrong: How Health Care Organizationa Deal With Failures. Retrieved January 15, 2014, from Health Affairs: content.healthaffairs.org/content/23/3/103.full