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Patient Safety
Charles Vincent
Churchill Livingstone Elsevier
ISBN 0443101205
First Published 2006
Paperback £19.99
In the last decade patient safety has risen to the top of the health care agenda in the United Kingdom and in many other Western countries. Various factors have contributed to this including a desire to reduce rising litigation costs, the need to restore public trust following incidents such as the Bristol paediatric cardiac surgery affair and the case of Harold Shipman, the setting and monitoring of safety targets and competitive pressures as private health care organisations, and open market pressures, lead to the use of safety management as a marketing tool.
Charles Vincent is one of the United Kingdom’s leading researchers in this field and his interests in patient safety, dating back to 1989, have raised awareness of this issue in the UK and contributed to NHS initiatives to tackle the problem. It was Vincent’s retrospective case record review work in 1999 that led to the estimate that around 10.8% of UK hospital admissions suffered an adverse event and that as many as 40,000 deaths per year could arise from iatrogenic and nosocomial causes.
Patient Safety is divided into 12 chapters and covers, amongst a range of topics, the evolution of patient safety, studies aimed at quantifying the scale of the problem, reporting and learning systems, examining how human error and system failures can lead to harm, investigating and learning from incidents, caring for patients who have been harmed by treatment and for staff who have been involved in serious incidents, developing organisational culture, leadership skills that foster safer health care practice and using IT systems to reduce errors. Each chapter is amply referenced for those wishing to research further into the subject area.
I have two small quibbles with the book. Firstly, while covering the work of the National Patient Safety Agency (NPSA) I was surprised to find no mention of the National Health Service Litigation Authority’s (NHSLA) decade long role in fostering the development of risk management in the NHS. Secondly, the author seemingly ascribes the General Medical Council’s failure to investigate the clinical abilities of doctors to a lack of powers, only rectified by the passing of the Medical (Professional Performance) Act of 1995. A reading of Donald Irvine’s The Doctors’ Tale or Dame Janet Smith’s comments in volume five of The Shipman Inquiry throws a different and less flattering light on the situation.
For anyone wishing an excellent overview of patient safety issues, their causes and the initiatives that have been put in place to improve the safety of health care then this interesting, readable and informative book can be heartily recommended.
Roger Shaw, MIRM, Head of Risk Management, City & Hackney Teaching Primary Care Trust
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