Misadventures in Health Care: Inside Stories

Misadventures in Health Care: Inside Stories

Misadventures in Health Care: Inside Stories

Misadventures in Health Care: Inside Stories

Synopsis

Misadventures in Health Care: Inside Stories presents an alternative approach to attributing the cause of medical error solely to the health care provider. That alternative, the systems approach, pursues why an incident occurs in terms of factors in the context of care that affect the care provider to induce an error. The basis for this approach is the fact that an error is an act, an act is behavior, and behavior is a function of the person interacting with the environment. Eleven vignettes illustrate the importance of the systems approach by describing health care incidents from the perspective of the care providers-the perspective that can identify the factors that actually affect the provider. These stories provide general readers with opportunities to apply their knowledge in analyzing incidents to identify error-inducing factors.

Excerpt

The second half of the 20th century has witnessed advances in medical practice and technology that can only be described as spectacular. the discovery of penicillin in 1928 and its first use to treat wounded soldiers in World War II forecast a dramatic increase in the number of drugs available to the modern practitioner. Not only have new drugs appeared in profusion, but also new methods of manufacturing them—genetic engineering, for example—have been devised. As a result, the U. S. Pharmacopoeia lists thousands of clinically approved drugs worthy of consideration, a number that taxes the capacity of human memories. Although the benefits of these developments cannot be denied, we have also become acutely aware that they have created new problems, because, for one thing, we are continually discovering complex interactions among drugs, and between drugs and the people who take them.

In another arena, artificial hip joints were first implemented in 1928. They, and the first kidney implant in the 1950s and the first heart transplant in 1967, paved the way for the tens of thousands of joint and organ replacements now performed each year. Today's replacements include the hips, knees, shoulders, wrists, heart, lungs, liver, heart valves, kidneys, pancreas, bone marrow, skin, and cornea and lens of the eye. Even as I write, I have read about the first total human hand replacement. Who can foresee what developments will follow that achievement?

Medical technology has more than kept pace with these other advances. Physicians had some specialized machines—for example, electro cardiographs, electroen cephalographs, X-ray equipment and renal dialysis machines—prior . . .

Search by... Author
Show... All Results Primary Sources Peer-reviewed

Oops!

An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.