patient_safety - A S PECIAL S UPPLEMENT TO THE H ASTINGS C...

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A S PECIAL S UPPLEMENT TO THE H ASTINGS C ENTER R EPORT Promoting PATIENT SAFETY V IRGINIA A. S HARPE T H E . . . . . . . . . . . . . . . HASTINGS . . . . . . . . . . . . . . . CENTER A N E THICAL B ASIS FOR P OLICY D ELIBERATION
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T his is the final report of a two- year Hastings Center research project that was launched in response to the landmark 1999 report from the Institute of Medicine, To Err Is Human , and the extraordinary atten- tion that policymakers at the federal, state, regulatory, and institutional lev- els are devoting to patient safety. It seeks to foster clearer and better dis- cussion of the ethical concerns that are integral to the development and implementation of sound and effec- tive policies to address the problem of medical error. It is intended for poli- cymakers, patient safety advocates, health care administrators, clinicians, lawyers, ethicists, educators, and oth- ers involved in designing and main- taining safety policies and practices within health care institutions. Among the topics discussed in the report: n the values, principles, and per- ceived obligations underlying pa- tient safety efforts; n the historical and continuing tensions between “individual” and “system” accountability, between error “reporting” to oversight agen- cies and error “disclosure” to pa- tients and families, and between aggregate safety improvement and the rights and welfare of individual patients; n the practical implications for patient safety of defining “respon- sibility” retrospectively, as praise or blame for past events, or prospec- tively, as it relates to professional obligations and goals for the fu- ture; n the shortcomings of tort liabili- ty as a means of building institu- tional cultures of safety, learning from error, supporting truth telling as a professional obligation, or ad- equately compensating patients and families, contrasted with alter- native models of dispute resolu- tion, including mediation and no- fault liability; n the needs of patients, families, and clinicians affected by harmful errors and how these needs may be addressed within systems ap- proaches to patient safety; and n the potential conflicts between the protection of patient privacy required by the Health Insurance Portability and Accountability Act and efforts to use patient data for the purposes of safety improve- ment, and how these conflicts may be resolved. Although this report is the work of the project’s principal investigator, not a statement of consensus, it draws from the insights of the interdiscipli- nary group of experts convened by The Hastings Center to make sense of the complex phenomenon of patient safety reform. Working group mem- bers brought their experience as peo- ple who had suffered from devastat- ing medical harms and as institution- al leaders galvanized to reform by tragic events in their own health care institutions. They brought expertise as clinicians, chaplains, and risk man- agers working to deliver health care,
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This note was uploaded on 04/07/2008 for the course PHI 4004 taught by Professor Ludy during the Spring '08 term at University of Central Florida.

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patient_safety - A S PECIAL S UPPLEMENT TO THE H ASTINGS C...

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