Reason's accident causation model: application to adverse events in acute care.
Adverse events are unintended harm to a patient caused by the health care provided; more than half of all these events have been deemed avoidable. Adverse events are a common problem in acute care and represent a breach in care quality and safety. They are generally not caused by a single mistake or error and although safety barriers exist in health care, patients today are still harmed. Using an accident causation model is a constructive way of identifying the underlying causes of adverse events and to strengthen a study's theoretical underpinnings. Reason's model is recommended as a useful framework for adverse event analysis as it promotes a focus on the conditions or situation in which the clinician was trying to perform, rather than apportioning blame.
St Vincent's Centre for Nursing Research, Australian Catholic University, Melbourne, VIC, Australia.
Malcolm
M
Elliott
Karen
K
Page
Linda
L
Worrall-Carter
D000208:Acute Disease; D015984:Causality; D006801:Humans; D019300:Medical Errors; D008962:Models, Theoretical