Alan Merry – författare

As more and more people survive into old age, the burden of caring for them becomes greater and greater. Although it is now possible to alleviate many of the afflictions that beset mankind, no society can afford to pay for all the healthcare that is now available or technically possible. People working in healthcare increasingly have to do more with less. Rationing takes many forms, mostly covert, and the less privileged in most societies end up struggling to get their proper share of the available healthcare resources. All too often, those in the front-line have to deal with the consequences of this 'rationing by default': healthcare professionals find themselves rushed off their feet simply doing the basic tasks and completing all the paperwork; placing frail, sick people in ever lengthening queues, sometimes asking them to wait for hours in the middle of the night under uncomfortable and even unsafe conditions; and, worst of all, working under conditions they would rather avoid in which the safety margin for those they are caring for has been greatly diminished. We are all aware that under these conditions the chance of making a mistake which can seriously harm or even lead to the death of a patient is greatly increased. But what can be done about this? How can you be sure that you are doing the right thing when faced with having to practise an uncertain science on vulnerable patients in a complex system under ever-changing conditions? At what point could you cross the invisible line from reasonable to irresponsible or unethical behaviour by tolerating conditions or tacitly accepting practices which may be regarded as unacceptable, even though you may have little immediate control over them? This book is a guide to getting it right for healthcare professionals. It is about doing the right thing, in the right way, at the right time, for the right people. These are the dimensions of quality in healthcare, and although some are in conflict (equitable access and efficiency, for example), adherence to ethical practice and professional behaviour will help lead healthcare practitioners through the minefield of responsibilities and priorities. Real-life situations are integral to the book, with over 500 clinical examples referred to within the text.

As more and more people survive into old age, the burden of caring for them becomes greater and greater. Although it is now possible to alleviate many of the afflictions that beset mankind, no society can afford to pay for all the healthcare that is now available or technically possible. People working in healthcare increasingly have to do more with less. Rationing takes many forms, mostly covert, and the less privileged in most societies end up struggling to get their proper share of the available healthcare resources. All too often, those in the front-line have to deal with the consequences of this 'rationing by default': healthcare professionals find themselves rushed off their feet simply doing the basic tasks and completing all the paperwork; placing frail, sick people in ever lengthening queues, sometimes asking them to wait for hours in the middle of the night under uncomfortable and even unsafe conditions; and, worst of all, working under conditions they would rather avoid in which the safety margin for those they are caring for has been greatly diminished. We are all aware that under these conditions the chance of making a mistake which can seriously harm or even lead to the death of a patient is greatly increased. But what can be done about this? How can you be sure that you are doing the right thing when faced with having to practise an uncertain science on vulnerable patients in a complex system under ever-changing conditions? At what point could you cross the invisible line from reasonable to irresponsible or unethical behaviour by tolerating conditions or tacitly accepting practices which may be regarded as unacceptable, even though you may have little immediate control over them? This book is a guide to getting it right for healthcare professionals. It is about doing the right thing, in the right way, at the right time, for the right people. These are the dimensions of quality in healthcare, and although some are in conflict (equitable access and efficiency, for example), adherence to ethical practice and professional behaviour will help lead healthcare practitioners through the minefield of responsibilities and priorities. Real-life situations are integral to the book, with over 500 clinical examples referred to within the text.

There is an understandable tendency or desire to attribute blame when patients are harmed by their own healthcare. However, many cases of iatrogenic harm involve little or no moral culpability. Even when blame is justified, an undue focus on one individual often deflects attention from other important factors within the inherent complexity of modern healthcare. This revised second edition advocates a rethinking of accountability in healthcare based on science, the principles of a just culture, and novel therapeutic legal processes. Updated to include many recent relevant events, including the Keystone Project in the USA and the Mid Staffordshire scandal in the UK, this book considers how the concepts of a just culture have been successfully implemented so far, and makes recommendations for best practice. This book will be of interest to anyone concerned with patient safety, medical law and the regulation of healthcare.

With medication errors in healthcare an internationally recognised problem, this much-needed book delivers a comprehensive approach to understanding medication safety in the perioperative period. It reviews what medication adverse events are, and how often and where these errors occur, as well as exploring human cognitive psychology and explaining why things can go wrong at any time in a complex system. Detailed discussions around mistakes, judgement errors, slips and lapses, and violations, are presented alongside real-life examples of the indistinct line between negligence and inevitable error. The co-authors bring a wide and practical perspective to the theories and interventions that are available to improve medication safety, including legal and regulatory actions that further or impede safety. Essential reading for anesthesiologists, nurses, pharmacists and other perioperative team members committed to improving medication safety for their patients, and also an invaluable resource for those who fund, manage and regulate healthcare.