Sunday, January 27, 2013

Need for reappraisal of notion of errors in healthcare

Very good article by Sonja Jerak-Zuiderent argues that patient safety needs to be conceptualised in terms of 'living with uncertainty' rather than errors in healthcare. Errors do not necessarily detract from safety and to ensure safety it is important to allow for the possibility that errors will occur. Practitioners live with uncertainty and a margin of error will always occur in their practice. This is not being complacent about iatrogenic damage and harm which is a major concern.

It is problematic to assume that safety will follow from protocols designed to reduce errors. In fact, safe practice requires an openness to change and the need for new responses. Creatively understanding what safety means in a specific instance can even require disregarding established protocols or guidelines. Assuming that safety will follow from protocols loses the benefit of living and acting in the real world. Mistakes need to be valued as a core element of life itself. Living with uncertainty does not mean that anything goes or that one is complacent about errors and is a safer mode of clinical practice.

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