Improving patient safety: patient-focused, high-reliability team training.
Healthcare systems are recognizing "human factor" flaws that result in adverse outcomes. Nurses work around system failures, although increasing healthcare complexity makes this harder to do without risk of error. Aviation and military organizations achieve ultrasafe outcomes through high-reliability practice. We describe how reliability principles were used to teach nurses to improve patient safety at the front line of care. Outcomes include safety-oriented, teamwork communication competency; reflections on safety culture and clinical leadership are discussed.
McKeon
Leslie M
LM
Acute and Chronic Care Department, The University of Tennessee Health Science Center, College of Nursing, 877 Madison Ave, Suite 600, Memphis, TN 38163, USA. lmckeon@utmem.edu
Cunningham
Patricia D
PD
Oswaks
Jill S Detty
JS
D002983:Clinical Competence; D006801:Humans; D007318:Inservice Training / Q000379:methods / Q000458:organization & administration; D009741:Nursing Staff, Hospital / Q000592:standards*; D015279:Organizational Culture; D010348:Patient Care Team / Q000592:standards*; D018802:Patient-Centered Care / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000379:methods* / Q000458:organization & administration; D012449:Safety