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In the book, Chapter 4 focuses on preventing mistakes, including methods like checklists and mistake-proofing. We should really try to avoid and prevent medication mistakes, considering the harm that can result (up to and including death). We can try to prevent mistakes while also emphasizing the need to learn from… Read More "Which Pharmacy Mistake Proofing Method is Better in This Scenario?"
In the news: Arnold Schwarzenegger Had Botched Heart Surgery Three Months Before ‘Terminator 6’ Filming, Doctor Poked Through Heart Wall: ‘I Was in the Middle of a Disaster’ What happened has been described as a “mistake.” “Schwarzenegger remembered the doctor telling him when he woke up, “We made a mistake… Read More "An Operating Room “Slip” Mistake Almost Killed Arnold Schwarzenegger"
Being oriented around learning from mistakes doesn’t mean we are flippant about mistakes and human error. There are some mistakes that we should work really hard to prevent through checklists, mistake-proofing methods, and good systems. Telling people to “be more careful” isn’t really effective. I saw this in the news… Read More "Losing a Patient’s Removed Tumor: A Mistake That Shouldn’t Happen, But Must be Learned From"
In the news: ‘Catalogue of errors’ in treatment of terminal man Leslie Boatfield died of bowel cancer. His surviving daughter complained about a series of errors. “It was a catalogue of errors and people not doing things,” Ms Price said. It doesn’t make everything OK, but “the University Hospitals Sussex… Read More "NHS Apologizes for Care Mistakes, Wishes Dead Man Well in Future Care"