Mistake-proofing healthcare: Why stopping processes may be a good start

Grout, John R.; Toussaint, John

doi:10.1016/j.bushor.2009.10.007

Cited by 45 publications

(29 citation statements)

References 3 publications

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“…This type of culture and HCW empowerment has been associated with robust patient safety practices. 21,22 Achieving the appropriate cultural among HCWs, however, has been shown to be challenging in hospital systems perhaps undermined, as we found, by inaccessible equipment.…”

Section: Discussionmentioning

confidence: 72%

Health care workers’ perceptions and reported use of respiratory protective equipment: A qualitative analysis

Fix

Reisinger

Etchin

et al. 2019

American Journal of Infection Control

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Background:Little is known about health care workers' (HCW) perceptions of, or experiences using, respiratory protective equipment (RPE). We sought to characterize their perceptions and identify reasons underlying inappropriate use. Methods: We conducted 12 focus groups with nurses and nursing assistants at 4 medical centers. We analyzed the thematic content of 73 discrete "stories" told by focus group participants. Results: We identified 5 story types surrounding RPE use: 1) policies are known and seen during work routines; 2) during protocol lapses, use is reinforced through social norms; 3) clinical experiences sometimes supersede protocol adherence; 4) when risk perception is high, we found concern regarding accessing RPE; and 5) HCWs in emergency departments were viewed as not following protocol because risk was ever-present. Discussion: HCWs were aware of the importance of RPE and protocols for using it, and these supported use when protocol lapses occurred. However, protocol adherence was undermined by clinical experience, perceived risk, and the distinct context of the emergency department where patients continually arrive with incomplete or delayed diagnoses. Conclusions: Protocols, visual cues, and social norms contribute to a culture of safety. This culture can be undermined when HCWs experience diagnostic uncertainty or they mistrust the protocol and instead rely on their clinical experiences.Published by Elsevier Inc. on behalf of Association for Professionals in Infection Control and Epidemiology, Inc.

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Section: Discussionmentioning

confidence: 72%

Health care workers’ perceptions and reported use of respiratory protective equipment: A qualitative analysis

Fix

Reisinger

Etchin

et al. 2019

American Journal of Infection Control

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“…Figure 4 gives an impression of the popularity of the commonly used Lean/Six Sigma tools. There are some papers which explained more than one tool like Grout and Toussaint 98 and Van Lent et al, 125 etc. The most common tools used for process mapping including (Value stream mapping, Process mapping, flow chart, etc.).…”

Section: Toolsmentioning

confidence: 98%

Lean Thinking and Six Sigma: proven techniques in industry. Can they help health care?

Shirazi¹,

Pintelon²

2013

International Journal of Care Pathways

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Lean Thinking and Six Sigma are quality management tools developed in an industrial context, where they have proven their usefulness for decades. More recently, these tools entered health care. Quite some literature on the application of these tools in health care has appeared since. This paper reviews this literature; more than 120 papers are studied and classified according to the nature of the paper: review, case study, strategy or tool description. Many case study papers were found. For these papers further analysis was made on the focus quality issue, the tools used and the area of implementation.

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“…Several methods may be used to determine and improve the value of a product or process by identifying how a product or process might fail and what effects might occur as the outcome. The examples of these methods are: Value Analysis, Lean Management, Poka-yoke (mistake-proofing) or Failure Mode and Effects Analysis (FMEA) and others (Agbejule et al 2004;Grout and Toussaint 2010;Karstoft and Tarp 2011). However, in comparison to others, FMEA assesses also the criticality of the failure modes on the product or process functionality.…”

Section: Introductionmentioning

confidence: 99%

The Risk Analysis of Metallic Foreign Bodies in Food Products

Trafiałek

Kaczmarek

Kolanowski

2016

Journal of Food Quality

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The aim of this study was to elaborate and validate the risk analysis procedure of metallic foreign bodies' occurrence in food. The enterprise selected for the study was a company processing dry foods. The procedure was based on Failure Mode and Effect Analysis. The implementation of the procedure allowed to find two production stages at risk of metallic particles' contamination, which were: reception of raw materials into the plant and packaging of finished products. The group of products at the highest risk of contamination was: buckwheat, prunes, brown cane sugar, brown flax and "tropical" muesli. The methods of risk management and the risk communication were established. The procedure may be a convenient tool for better food safety assurance and can be used in many food processing enterprises where the risk of metallic foreign bodies' occurrence in finished products is high. PRACTICAL APPLICATIONSMetallic foreign bodies are common in some kinds of food. Occurrence of metallic foreign bodies significantly decreases food safety. The procedure elaborated and validated in this study is based on Failure Mode and Effect Analysis. The implementation of the procedure allows to find production stages at risk of metallic particles' contamination. The procedure may be a convenient tool for better food safety assurance and can be used in many food processing enterprises where the risk of metallic foreign bodies' occurrence in finished products is high.

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Mistake-proofing healthcare: Why stopping processes may be a good start

Cited by 45 publications

References 3 publications

Health care workers’ perceptions and reported use of respiratory protective equipment: A qualitative analysis

Health care workers’ perceptions and reported use of respiratory protective equipment: A qualitative analysis

Lean Thinking and Six Sigma: proven techniques in industry. Can they help health care?

The Risk Analysis of Metallic Foreign Bodies in Food Products

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