Engineering a safe landing: engaging medical practitioners in a systems approach to patient safety

Brand, Caroline; Ibrahim, Joseph E.; Bain, Christopher; Jones, Cason; King, Barbara J.

doi:10.1111/j.1445-5994.2007.01310.x

Cited by 7 publications

(5 citation statements)

References 27 publications

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“…The traditional, punitive, person-centred approach generally fails to improve performance and also leads to a secretive culture where accidents and mistakes are often hidden, making it even harder to recognize the underlying problems. Consideration has also been given to patient safety (Brand et al 2007;Womer et al 2002), inadequate care (Cho 2001) and mismanaged pain (McNeill et al 2004).…”

Section: Medicine and Healthmentioning

confidence: 99%

A review of the recent contribution of systems thinking to operational research and management science

Mingers

White

2010

European Journal of Operational Research

353

229

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The systems approach, or systems thinking, has been intimately connected with the development of OR and management science initially through the work of founders such as Churchman and Ackoff and latterly through innovations such as soft systems. In this paper we have undertaken a review of the contribution that systems thinking has been making more recently, especially to the practice of OR. Systems thinking is a discipline in its own right, with many theoretical and methodological developments, but it is also applicable to almost any problem area because of its generality, and so such a review must always be selective. We have looked at the literature from both a theoretical and an applications orientation. In the first part we consider the main systems theories and methodologies in terms of their recent developments and also their applications. This covers: the systems approach, complexity theory, cybernetics, system dynamics, soft OR and PSMs, critical systems and multimethodology. In the second part we review the main domains of application: strategy, information systems, organisations, production and operations, ecology and agriculture, and medicine and health. Our overall conclusion is that while systems may not be well established institutionally, in terms of academic departments, it is incredibly healthy in terms of the quantity and variety of its applications.

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Section: Medicine and Healthmentioning

confidence: 99%

A review of the recent contribution of systems thinking to operational research and management science

Mingers

White

2010

European Journal of Operational Research

353

229

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“…The idea was to have a practical instrument rather than a scientific tool to assess how engagement is sought and developed. Other assessment questionnaires focused on the levels, determinants, and barriers to engagement, such as the hospital-physician engagement agreement [ 109 ] or the systems approach to patient safety and quality [ 110 ].…”

Section: Resultsmentioning

confidence: 99%

“…About 60% of reviewed items ( n = 104; 59.8%) discussed factors impeding physician engagement. The main issues concern individual attitudes and skills, conflict between managerial and clinical culture [ 56 ] mistrust toward managers [ 57 , 117 – 119 ], and frustration from a sense of loss of autonomy [ 20 , 110 , 118 ] Due to these factors, physicians are reluctant to take on a management role [ 46 , 120 , 121 ].…”

Section: Resultsmentioning

confidence: 99%

Exploring physician engagement in health care organizations: a scoping review

Prenestini,

Palumbo,

Grilli

et al. 2023

BMC Health Serv Res

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Rationale Enhancing health system effectiveness, efficiency, and appropriateness is a management priority in most world countries. Scholars and practitioners have focused on physician engagement to facilitate such outcomes. Objectives Our research was intended to: 1) unravel the definition of physician engagement; 2) understand the factors that promote or impede it; 3) shed light on the implications of physician engagement on organizational performance, quality, and safety; and 4) discuss the tools to measure physician engagement. Method A scoping review was undertaken. Items were collected through electronic databases search and snowball technique. The PRISMA extension for Scoping Reviews (PRISMA-ScR) statement and checklist was followed to enhance the study replicability. Results The search yielded 16,062 records. After an initial screening, 300 were selected for potential inclusion in this literature review. After removing duplicates and records not meeting the inclusion criteria, full-text analysis of 261 records was performed, yielding a total of 174 records. Discussion Agreement on the conceptualization of physician engagement is thin; furthermore, scholars disagree on the techniques and approaches used to assess its implementation and implications. Proposals have been made to overcome the barriers to its adoption, but empirical evidence about implementing physician engagement is still scarce. Conclusions Our scoping review highlights the limitations of the extant literature about physician engagement. Physician engagement is a relatively ill-defined concept: developing an evidence base for its actual implementation is necessitated to provide reliable guidance on how the governance of health care organizations could be improved. Although we did not assess the quality or the robustness of current empirical research, our findings call for further research to: 1) identify potential drivers of physician engagement, 2) develop dependable assessment tools providing health care organizations with guidance on how to foster physician engagement, and 3) evaluate engagement’s actual impact on health care organizations’ performance.

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“…Doctors, as main participants have been called upon to address the underlying systems causes of medical error and harm. Unfortunately, several studies have shown that even by 2007 more than half of hospital doctors surveyed 5 had not even heard of the report, To Err Is Human .…”

Section: Patient Safety and Medical Errorsmentioning

confidence: 99%

Doctor-patient relationships, laws, clinical guidelines, best practices, evidence-based medicine, medical errors and patient safety

Violato

2013

Can. Med. Ed. J

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Patient safety has now become a mantra of modern medical practice. Rules, laws, guidelines, evidence and best practices are frequently invoked to improve patient safety. These are not new; they have governed the practice of medicine since antiquity. A set of laws, known as the Code of Hammurabi (circa 1740 B.C.E.) have come down to us from the Babylonians after its namesake, the founder of the Babylonian empire. 1 These 282 statues or common laws governed nearly all aspects of social, political, economic and professional life including those pertaining to physicians, surgeons, veterinarians, midwifes and wet nurses. Carefully conscribed details were devoted to specifying the relationship between patients and practitioners, including fees and penalties. Problems of "internal medicine" were dealt with physicians of the priestly class who saw to internal disorders caused by supernatural factors.

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Engineering a safe landing: engaging medical practitioners in a systems approach to patient safety

Abstract: Several factors are limiting engagement of medical practitioners in a systems approach to patient safety. Increased educational support is needed and may be best focused within clinical effectiveness activities pertinent to practitioner interest and expertise.

Cited by 7 publications

References 27 publications

A review of the recent contribution of systems thinking to operational research and management science

A review of the recent contribution of systems thinking to operational research and management science

Exploring physician engagement in health care organizations: a scoping review

Doctor-patient relationships, laws, clinical guidelines, best practices, evidence-based medicine, medical errors and patient safety

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