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Appendix E: Safety Activities in Health Care Organizations
Pages 266-272

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From page 266...
... or the American Osteopathic Association. A brief review of widely implemented safety programs in health care facilities, then, is grounded in the state licensing or, more likely, the voluntary accreditation standards of accrediting bodies such as the JCAHO.
From page 267...
... Such infection control processes are managed by individuals who are assigned the responsibility of surveillance, reporting, and investigating outbreaks of nosocomial infections (infections acquired while in health care that are unrelated to the original condition) , and putting in place and monitoring the results of processes to prevent or reduce the risk of infectious transmission.
From page 268...
... before examination, maternal mortality decreased from 18 percent to 2.4 percent in the first month.3 4 According to CDC, even today, "handwashing is the single most important means of preventing the spread of infection." Yet, repeated studies indicate that after more than 150 years of experience, lack of or improper handwashing still contributes significantly to disease transmission in health care settings5-1l Exhortations to personnel have not been effective, and some organizations have begun to look at system barriers to handwashing (e.g., the time required as well as the chapping and irritation caused by frequent handwashing) and ways to eliminate these problems by designing better hand hygiene processes.
From page 269...
... The value of the M&M conference is highly dependent on how the department chair uses it, but a recent national survey on attitudes and opinions of the value of M&M conferences found that 43 percent of residents and 47 percent of surgical faculty believed that the conference was an important and powerful educational tool.12 Lower rankings were given to its value in reducing error and improving care. M&M conferences are case-by-case reviews, with an emphasis on learning what might have been done differently in a given case rather than punishment, but they stress the value of knowledge, skill, and alertness to anticipate problems.13 They tend not to address systemic issues.
From page 270...
... Although risk management committees include a member of the medical staff, risk management has not been embraced at the organizational leadership level in its broadest sense of patient safety protecting patients from any accidental injury. Risk managers interact when necessary with the administrator or chief executive officer, medical director or chief of staff, nursing director, medical records director, and chief financial officer, but the function of improved patient safety is not, typically, represented through risk managers on the governing board's executive committee or at corporate headquarters.
From page 271...
... Handbook of Health Care Risk Management. Rockville, MD: Aspen, 1986.

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