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Article

Amjad Mohamadi-Bolbanabad, Ghobad Moradi, Bakhtiar Piroozi, Hossein Safari, Heshmatollah Asadi, Karim Nasseri, Hiwa Mohammadi and Abdorrahim Afkhamzadeh

The purpose of this paper is to determine the second victims’ experience and its related factors among medical staff.

Abstract

Purpose

The purpose of this paper is to determine the second victims’ experience and its related factors among medical staff.

Design/methodology/approach

This research is a cross-sectional study that was conducted in public hospitals of Sanandaj, west of Iran, in 2017. The sample consisted of 338 medical staff including physicians, nurses and mid-wives. A self-report questionnaire was used for data collection. Descriptive statistics, cross-tabs and χ2 test were used for data analysis using SPSS20.

Findings

A total of 51.5 percent (n=174) of the medical staff had experienced medical error in the past year, of which 90.2 percent (n=157) had at least one of the symptoms of “second victims.” Tachycardia and sleep disturbances were the most commonly referred physical symptoms with 73 and 51.7 percent, respectively. Also, repetitive/intrusive memories and fear of reputation damage were the most commonly referred psychosocial symptoms with 68.3 and 51.7 percent, respectively. The experience of physical and psychosocial symptoms was different according to the occupational category. In addition, there was a significant association between the experience of physical symptoms with the hospital administrators’ awareness of medical errors and the consequences of medical errors for patients.

Practical implications

Adoption of coping strategies, including learning from medical errors as well as hospital administrators’ support from second victims, is recommended. It is also suggested that medical staff be informed about the consequences of medical errors as well as physical and psychological symptoms of second victims so that they can ask for help from managers and colleagues when the symptoms occur.

Originality/value

This study outlines the prevalence, the most psychological and physical symptoms, and the demographic and occupational factors associated with the second victim phenomenon in medical staff. Also, the most important strategies for coping with this phenomenon are prioritized from the perspective of medical staff.

Details

International Journal of Workplace Health Management, vol. 12 no. 3
Type: Research Article
ISSN: 1753-8351

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Article

Lee C. Jarvis

The purpose of this paper is to help introduce the empirical study of emotion within an institutional framework by examining shame and shaming as drivers of institutional…

Abstract

Purpose

The purpose of this paper is to help introduce the empirical study of emotion within an institutional framework by examining shame and shaming as drivers of institutional stability and change, respectively.

Design/methodology/approach

The author conducted a qualitative study of 101 US print media articles generated by major US news publications and trade magazines from 1999 to 2011 in the wake of the Institute of Medicine’s (IOM) 1999 report To Err is Human: Building a Safer Health System.

Findings

This study resulted in two major findings. First, this research found that the institutions constituting the collective professional identity of physicians persisted via institutionalized shame inculcated in physicians during their extensive socialization into the medical profession. Potential shame over medical error served to reinforce institutionalized cultures which exacerbated medicine’s problems with error reporting. Second, this study reveals that field-level actors engage in shaming to affect institutional change. This research suggests that the IOM report was in effect a shaming effort directed at physicians and the institutions constituting their collective identity.

Research limitations/implications

This study provides some verification of recent theoretical works incorporating emotion into institutional theory and also illustrates how shame can be incorporated into collective identity as an institutional imperative.

Originality/value

This study provides a rare empirical investigation of emotion within an institutional framework, and illuminates ways in which the emotion of shame interacts with institutional processes. This research also focusses on collective identity and institutional stability, two topics which are largely ignored by contemporary institutional researchers but are integral aspects of social life.

Details

International Journal of Sociology and Social Policy, vol. 36 no. 3/4
Type: Research Article
ISSN: 0144-333X

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Article

Sameer Kumar and Marc Steinebach

Healthcare costs in the USA have continued to rise steadily since the 1980s. Medical errors are one of the major causes of deaths and injuries of thousands of patients…

Abstract

Purpose

Healthcare costs in the USA have continued to rise steadily since the 1980s. Medical errors are one of the major causes of deaths and injuries of thousands of patients every year, contributing to soaring healthcare costs. The purpose of this study is to examine what has been done to deal with the medicalerror problem in the last two decades and present a closed‐loop mistake‐proof operation system for surgery processes that would likely eliminate preventable medical errors.

Design/methodology/approach

The design method used is a combination of creating a service blueprint, implementing the six sigma DMAIC cycle, developing cause‐and‐effect diagrams as well as devising poka‐yokes in order to develop a robust surgery operation process for a typical US hospital.

Findings

In the improve phase of the six sigma DMAIC cycle, a number of poka‐yoke techniques are introduced to prevent typical medical errors (identified through cause‐and‐effect diagrams) that may occur in surgery operation processes in US hospitals. It is the authors' assertion that implementing the new service blueprint along with the poka‐yokes, will likely result in the current medical error rate to significantly improve to the six‐sigma level. Additionally, designing as many redundancies as possible in the delivery of care will help reduce medical errors.

Practical implications

Primary healthcare providers should strongly consider investing in adequate doctor and nurse staffing, and improving their education related to the quality of service delivery to minimize clinical errors. This will lead to an increase in higher fixed costs, especially in the shorter time frame.

Originality/value

This paper focuses additional attention needed to make a sound technical and business case for implementing six sigma tools to eliminate medical errors that will enable hospital managers to increase their hospital's profitability in the long run and also ensure patient safety.

Details

International Journal of Health Care Quality Assurance, vol. 21 no. 5
Type: Research Article
ISSN: 0952-6862

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Article

Gary C. David, Donald Chand and Balaji Sankaranarayanan

– The purpose of the paper is to determine the instance of errors made in physician dictation of medical records.

Abstract

Purpose

The purpose of the paper is to determine the instance of errors made in physician dictation of medical records.

Design/methodology/approach

Purposive sampling method was employed to select medical transcriptionists (MTs) as “experts” to identify the frequency and types of medical errors in dictation files. Seventy-nine MTs examined 2,391 dictation files during one standard work day, and used a common template to record errors.

Findings

The results demonstrated that on the average, on the order of 315,000 errors in one million dictations were surfaced. This shows that medical errors occur in dictation, and quality assurance measures are needed in dealing with those errors.

Research limitations/implications

There was no potential for inter-coder reliability and confirming the error codes assigned by individual MTs. This study only examined the presence of errors in the dictation-transcription model. Finally, the project was done with the cooperation of MTSOs and transcription industry organizations.

Practical implications

Anecdotal evidence points to the belief that records created directly by physicians alone will have fewer errors and thus be more accurate. This research demonstrates this is not necessarily the case when it comes to physician dictation. As a result, the place of quality assurance in the medical record production workflow needs to be carefully considered before implementing a “once-and-done” (i.e. physician-based) model of record creation.

Originality/value

No other research has been published on the presence of errors or classification of errors in physician dictation. The paper questions the assumption that direct physician creation of medical records in the absence of secondary QA processes will result in higher quality documentation and fewer medical errors.

Details

International Journal of Health Care Quality Assurance, vol. 27 no. 2
Type: Research Article
ISSN: 0952-6862

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Article

Sushil Kumari Jindal and Faryal Raziuddin

The purpose of this paper is to present the findings of a research study conducted to find the perceptions of medical professionals about reduction in medical errors using…

Abstract

Purpose

The purpose of this paper is to present the findings of a research study conducted to find the perceptions of medical professionals about reduction in medical errors using electronic medical records (EMRs). It presents the relationship between EMR use in medical facilities and the reduction in medical errors. The use of EMR can lead to competitive advantages in the health-care environment.

Design/methodology/approach

This paper is based upon the perceptions of 99 medical professionals who use EMR in their practice in Arizona, USA.

Findings

This paper presents the medical professionals who use EMR which reduces medical errors, wrong site surgery, improper dosage delivery to a patient, wrong medication, etc. by 50-60 per cent.

Research limitations/implications

This paper is limited to perceived reductions in medical errors because the actual number of errors is either unavailable or medical professionals are unwilling to provide. Future research should seek conducting database searches to find medical malpractice lawsuits, unexpected costs or any reference to quantifying losses because of medical errors. Once the expenses are reported, relating to medical malpractice legal costs with the cost of investing in EMR system would prove an excellent observational study.

Practical implications

Medical professionals, medical facilities and patients should be aware of the impact EMRs have on the healthcare provided as well as the safety of patients enabled by the EMRs.

Social implications

Health-care industry is operating in a crisis mode and before it turns chaotic, there needs to be a consistent product used by every health-care organization or practice. EMRs can automatically update patients’ information that is required on a routine basis via different computing systems such as cloud, minimizing the need for information technology professionals to handle the issues. This leads to reduced cost, increased efficiency, effectiveness and better management of the patients’ health and wellness outcomes, with perceived reduction in medical errors.

Originality/value

The value of this research report is to provide the various features EMR offers and how it helps to reduce medical mistakes that help in avoiding repetition of different tests, incorrect dosage delivery and interaction of various medicines a patient is taking.

Details

International Journal of Quality and Service Sciences, vol. 10 no. 1
Type: Research Article
ISSN: 1756-669X

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Article

Ghasem Abedi, Ghahraman Mahmoodi, Roya Malekzadeh, Zeinab Khodaei, Yibeltal Siraneh Belete and Edris Hasanpoor

The regulation defines patients’ rights as a reflection of fundamental human rights in the field of medicine and incorporates all elements of patients’ rights accepted in…

Abstract

Purpose

The regulation defines patients’ rights as a reflection of fundamental human rights in the field of medicine and incorporates all elements of patients’ rights accepted in international texts. Hence, the purpose of this paper is to investigate the relationship between patients’ safety, medical errors and patients’ safety rights with patients’ security feeling in selected hospitals of Mazandaran Province, Iran.

Design/methodology/approach

This descriptive cross-sectional study was conducted in selected hospitals of Mazandaran Province in public, social and private hospitals in 2016. In total, 1,083 patients were randomly selected for the study. The developed tool (questionnaire) was used for data collection. Questionnaire validity was verified through experts and its reliability was confirmed by Cronbach’s α coefficient (95 percent). Data were analyzed through multiple regressions by SPSS software (version 21).

Findings

The findings of this paper showed that the mean (standard deviation) medical error, patient’s safety, patient’s rights and patient’s security feeling were 2.50±0.61, 2.22±0.67, 2.11±0.68 and 2.73±0.63, respectively. Correlation testing results showed that medical error, patient’s safety and patient’s rights simultaneously had a significant relation with patient’s security feeling in the selected hospitals (p<0.05).

Originality/value

A simultaneous correlation between patient’s safety, patient’s rights and medical errors with patient’s security feeling in social security hospitals was higher than other hospitals. Hence, the authorities and officials of hospitals and healthcare centers were advised to make effective attempts to perceive the patient’s safety, medical errors and patient’s rights to improve the patient’s security feeling and calmness and also to make better decisions to promote the healthcare and therapeutic services.

Details

International Journal of Human Rights in Healthcare, vol. 12 no. 3
Type: Research Article
ISSN: 2056-4902

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Article

Maryati Yusof and Mohamad Norzamani Sahroni

The purpose of this paper is to present a review of health information system (HIS)-induced errors and its management. This paper concludes that the occurrence of errors

Abstract

Purpose

The purpose of this paper is to present a review of health information system (HIS)-induced errors and its management. This paper concludes that the occurrence of errors is inevitable but it can be minimised with preventive measures. The review of classifications can be used to evaluate medical errors related to HISs using a socio-technical approach. The evaluation could provide an understanding of errors as a learning process in managing medical errors.

Design/methodology/approach

A literature review was performed on issues, sources, management and approaches to HISs-induced errors. A critical review of selected models was performed in order to identify medical error dimensions and elements based on human, process, technology and organisation factors.

Findings

Various error classifications have resulted in the difficulty to understand the overall error incidents. Most classifications are based on clinical processes and settings. Medical errors are attributed to human, process, technology and organisation factors that influenced and need to be aligned with each other. Although most medical errors are caused by humans, they also originate from other latent factors such as poor system design and training. Existing evaluation models emphasise different aspects of medical errors and could be combined into a comprehensive evaluation model.

Research limitations/implications

Overview of the issues and discourses in HIS-induced errors could divulge its complexity and enable its causal analysis.

Practical implications

This paper helps in understanding various types of HIS-induced errors and promising prevention and management approaches that call for further studies and improvement leading to good practices that help prevent medical errors.

Originality/value

Classification of HIS-induced errors and its management, which incorporates a socio-technical and multi-disciplinary approach, could guide researchers and practitioners to conduct a holistic and systematic evaluation.

Details

International Journal of Health Care Quality Assurance, vol. 31 no. 8
Type: Research Article
ISSN: 0952-6862

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Article

Hulda G. Black, Emily A. Goad and Jill S. Attaway

The purpose of this research is to investigate the relationship among jurors’ attribution of responsibility of the error, patient styles and juror decisions (e.g…

Abstract

Purpose

The purpose of this research is to investigate the relationship among jurors’ attribution of responsibility of the error, patient styles and juror decisions (e.g. acquittal of the physician). Specifically, this research examines the influence of an individual’s approach to their healthcare (active vs. passive), and decisions to acquit in malpractice cases.

Design/methodology/approach

In total, 459 individuals were surveyed using a commercial call center for participation in a corresponding mail survey. Surveys were also distributed to undergraduate business students at a Midwestern university.

Findings

Cluster analysis revealed two categories of patient styles: “active patients” (39.4 per cent) and “passive patients” (60.6 per cent). Regardless of patient style, this research found all respondents viewed medical error disclosure as important. However, respondents in the passive group were more likely to acquit the physician and the hospital nursing staff as compared with those classified as active.

Practical implications

The safety of patients in the healthcare system and prevention of errors is a critical issue. However, when errors occur, medical providers should disclose information to the patient and take responsibility to attenuate their negative impact. Further, this research reveals that patients who rely more on their physicians, trust their recommendations and question physicians less are more likely to acquit. Medical providers can use this information as motivation to continue to build this type of trust with their patients.

Originality/value

Medical errors are costly for all parties involved. This research provides insight for not only members of the legal profession involved in medical malpractice cases, but also risk managers and hospital administrators and healthcare providers regarding the decision-making process used by individuals serving on a jury.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 12 no. 1
Type: Research Article
ISSN: 1750-6123

Keywords

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Article

Jamison V. Kovach, Lee Revere and Ken Black

This study aims to provide healthcare managers with a meaningful synthesis of state of the art knowledge on error proofing strategies. The purpose is to provide a…

Abstract

Purpose

This study aims to provide healthcare managers with a meaningful synthesis of state of the art knowledge on error proofing strategies. The purpose is to provide a foundation for understanding medical error prevention, to support the strategic deployment of error proofing strategies, and facilitate the development and implementation of new error proofing strategies.

Design/methodology/approach

A diverse panel of 40 healthcare professionals evaluated the 150 error proofing strategies presented in the AHRQ research monograph using classification systems developed by earlier researchers. Error proofing strategies were ranked based on effectiveness, cost, and ease of implementation as well as based on their aim/purpose, i.e. elimination, replacement, facilitation, detection, or mitigation of errors.

Findings

The findings of this study include prioritized lists of error proofing strategies from the AHRQ manual based on the preferred characteristics (i.e. effectiveness, cost, ease of implementation) and underlying principles (i.e. elimination, replacement, facilitation, detections mitigation of errors) associated with each strategy.

Research limitations/implications

The results of this study should be considered in light of certain limitations. The sample size of 40 panelists from hospitals, medical practices, and other healthcare related companies in the Gulf Coast region of the USA prevents a stronger generalization of the findings to other groups or settings. Future studies that replicate this approach, but employ larger samples, are appropriate. Through the use of public forums and expanded sampling, it may be possible to further validate research findings in this paper and to expand and build on the results obtained in this study.

Practical implications

Using the error‐proofing strategies identified provides a starting point for researchers seeking to better understand the impact of error proofing on healthcare services, the quality of those services and the potential financial ramifications. Further, the results presented enhance the strategic deployment of error proofing strategies by bringing to light some of the important factors that healthcare managers should consider when implementing error proofing solutions. Most notably, healthcare managers are encouraged to implement effective solutions, rather than those that are merely inexpensive and/or easy to implement, which is more often the case.

Originality/value

This study provides a much‐needed forum for sharing error‐proofing strategies, their effectiveness, and their implementation.

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Article

Pouyan Esmaeilzadeh, Spurthy Dharanikota and Tala Mirzaei

Patient-centric exchanges, a major type of Health Information Exchange (HIE), empower patients to aggregate and manage their health information. This exchange model helps…

Abstract

Purpose

Patient-centric exchanges, a major type of Health Information Exchange (HIE), empower patients to aggregate and manage their health information. This exchange model helps patients access, modify and share their medical information with multiple healthcare organizations. Although existing studies examine patient engagement, more research is required to investigate patients' attitudes and willingness to play an active role in patient-centered information exchange. The study's main objective is to develop a model based on the belief-attitude-intention paradigm to empirically examine the effects of patients' attitudes toward engagement in care on their willingness to participate in patient-centric HIE.

Design/methodology/approach

The authors conducted an online survey study to identify the antecedents and consequences of patients' attitudes toward engagement in care. To empirically test the research model, the authors collected data from a national sample (n = 357) of individuals in the United States. The data were analyzed using structural equation modeling (SEM).

Findings

The proposed model categorizes the antecedents to patients' attitudes toward engagement in patient-related and healthcare system factors. The results show that patient-related factors (perceived health literacy and perceived coping ability) and health system factors (perceived experience with the healthcare organization and perceived patient-provider interaction) significantly shape patient attitude toward care management engagement. The results indicate that patients' attitudes toward engaging in their healthcare significantly contribute to their willingness to participate in medical information sharing through patient-centric HIE initiatives. Moreover, the authors’ findings also demonstrate that the link between patient engagement and willingness to participate in HIE is stronger for individuals who perceive lower levels of privacy and security concerns.

Originality/value

The authors validate the proposed model explaining patients' perceptions about their characteristics and the healthcare system significantly influence their attitude toward engaging in their care. This study also suggests that patients' favorable attitude toward engagement can bring patient-centric HIE efforts onto a path to success. The authors’ research attempts to shed light on the importance of patients' roles in adopting patient-centric HIE initiatives. Theoretical and practical contributions of this study are noticeable since they could result in a deeper understanding of the concept of patient engagement and how it may affect healthcare services in an evolving digital world. The authors’ findings can help healthcare organizations provide public citizen-centric services by introducing user-oriented approaches in healthcare delivery systems.

Details

Information Technology & People, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0959-3845

Keywords

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