Safety and Ethics in Healthcare: A Guide to Getting it Right

Bill Runciman is Professor of Anaesthesia and Intensive Care at the Adelaide University and Head of the Department of Anaesthesia and Intensive Care at the Royal Adelaide Hospital. He founded the Australian Patient Safety Foundation in 1988, and is the current President. He has been a member of task forces which produced world patient safety standards for both Anaesthesia and Intensive Care. He was Chairman of the Safety and Quality of Practice Committee of the World Federation of Societies of Anaesthesiologists from 1992 to 2000. He has been a member of the Australian Council for Safety and Quality in Healthcare and of the Australian Health Information Council, and is joint co-ordinator of groups developing research tools and an International Patient Safety Classification for the World Alliance for Patient Safety of the World Health Organization. Alan Merry is Professor of Anaesthesiology at the University of Auckland. He chairs the Quality and Safety Committee of the World Federation of Societies of Anaesthesiologists. He is a Councillor of the Australian and New Zealand College of Anaesthetists, chairs the College's Quality and Safety Committee, and has chaired its New Zealand National Committee. He co-chaired the New Zealand Medical Law Reform Group and has been president of the Auckland Medico-Legal Society. He is co-author of the books Errors, Medicine and the Law (with Alexander McCall Smith; Cambridge University Press, 2001) and Essential Perioperative Transoesophageal Echocardiography (with David Sidebotham and Malcolm Legget; Butterworth-Heinemann, 2003). Merrilyn Walton is an Associate Professor in the Faculty of Medicine at the University of Sydney. She chairs the Personal and Professional Development Theme and teaches students and clinicians about ethical practice, quality and safety. Her interests include enhancing the training environment for medical students and doctors and advocating for patients to be fully engaged in health care at every level. She was the founding Commissioner for the NSW Health Care Complaints Commission (1993-2000), and is a board member of the NSW Institute for Medical Education and Training and chairs its Prevocational Training Council.

'This book is indeed a worthy addition to the debate on healthcare safety and quality. It is accessible and underscores the essential humanity in providing safe, technically advanced care. Fucusing on health systems shifts responsibility away from a simplistic individual or profession approach to a collective approach where all the stakeholders are involved: individuals, patients, healthcare teams, organisations, together with local, national and international levels of healthcare policy and decision making. Nurses' experiences in healthcare teams are not well-discussed: issues such as the impact of staff shortage and fatigue are discussed from a predominantly medical point of view. Having said this, I recommend strongly that nursing leaders read and re-read this book. Above all, it is imperative that systems and professionals provide effective and safe healthcare, and this rests with the whole healthcare team.' Journal of Advanced Nursing, 2007 '...this book is very good value and should be readily available in every area of our healthcare system. I am not aware of any other text so up to date and comprehensive.' Anaesthesia and Intensive Care Vol 35 No 5 October 2007 'The authors treat the topic "safety management in medicine" and turn thereby to one of the most urgent areas of research and development in surgery. Particularly in chapters 2 "Understanding the basics" and 3 "What to do when things go wrong" definitions and concepts from the field of Human Factors are introduced which are unknown in surgery so far. This is of great importance, because due to the introduction of assistance systems and advanced workflow-management techniques into the operating room, an enormous need exists to arrive at such a new description of the hospital as a high-risk environment. Our working group already took over numerous recommendations of the authors. For example, a meeting to openly discuss complications during surgical procedures was established on a regular basis. In addition, a working group of 6 scientists will take up work on the topic of consequences of surgical automation. The book is highly recommended for all surgeons in complex treatment mechanisms.' Human Factors & Ergonomics Society Newsletter no2/2007 'This book provides a rare overview of the difficulties affecting the safe and ethical delivery of healthcare at all these levels. Ultimately the message of the book is optimistic because it highlights many areas where change is needed, and demonstrates that large-scale change is possible.' Prometheus, Vol 26, No 2, June 2008 '...the book presents an extremely interesting read for those closely involved with the delivery of health care and/or its implications' Critical Public Health, September 2008

• Contents: Foreword; Preface. Part 1 What is Wrong with Healthcare: Setting the stage: an overview of healthcare; Risk and the harm caused by healthcare; Healthcare: a dysfunctional system; Naming, blaming and shaming. Part 2 Understanding the Basics: Human error and complex systems; Knowing what to do; Ethics, professional behaviour and regulation. Part 3 What to Do When Things Go Wrong: When things go wrong: looking after the people involved; When things go wrong: preventing a recurrence. Part 4 Preventing Things from Going Wrong: Getting the best out of people; Getting the best out of the system; Where to now? Appendices: Preferred terms and definitions for key safety and quality concepts; Public expenditure on healthcare in selected countries; Risk matrix; Evidence-based medicine: sources of information; International code of medical ethics; Jonsen's ethics framework; Severity assessment code (SAC); The advanced incident monitoring system (AIMS); Soft systems methodology (SSM); Sources of information for patients. Index.