BMJ 2000;321:505 ( 19 August )

Letters

Reducing error, improving safety

    Defensive culture of British medicine needs to change
    Log of errors is needed
    Relation between reported mishaps and safety is unclear
    No fault compensation protects patients in Nordic countries
    Doctors could certainly take lessons from aviation
    "Do all things practicable to reduce risk" should apply in health system
    Health professionals should take responsibility for gross carelessness
    Blaming individuals is more emotionally satisfying than targeting institutions
    Medical errors must be discussed during medical education
    Safety of systems can often be improved
    Systems approach to intrapartum risk management is important
    Crew resource management training should be mandatory in anaesthesia
    Anaesthesia is different from anaesthesiology
    Technology cannot replace healthcare workers

Defensive culture of British medicine needs to change

The first 150 words of the full text of this article appear below.

EDITOR---It was brave to devote a whole issue to medical error1---how to recognise, how to investigate, how to analyse, and how to change systems to improve patient safety.1 However, we regret that the edition was dominated by American studies, ignoring the British contribution of confidential inquiries and analyses of closed claims, which have significantly improved safety in some well defined areas of medical practice.

In the United States the insurance industry provided the impetus for the study of adverse events,2 and in Australia the government funded a similar study3 because it was considering "no fault" compensation.3 In the United Kingdom, for 25 years the Department of Health has financed all successful claims against NHS hospitals and their staff. As a result the need to take a British study beyond the pilot phase may not be supported.4

Be that as it may, an important issue was not addressed in . . . [Full text of this article]
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This article has been cited by other articles:

  • Spencer, S A, Brewer, B., Tan, E., O'Loughlin, C., Westlake, W., Vive, J, Fergusson, N., MacQueen, R., Jarmulowicz, M., Paton, J., Bennett-Richards, P., Anonymous, , Davies, S. (2001). Cheating at medical school. BMJ 322: 296-296 [Full text]  

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