PARTNERING WITH PATIENTS TO REDUCE MEDICAL ERROR

Patricia L. Spath, Editor, American Hospital Association One North Franklin, 27th Floor Chicago, IL 60606, tel.: (800) 242-2626; fax (312) 422-4505; e-mail: http://www.ahaonlinestore.com 2004, 216 pp., ISBN-1-55648-314-7, hardcover, $75.00

Partnering with Patients to Reduce Medical Errors, edited by Patrice L. Spath, challenges the healthcare provider to put the "patient" in patient safety. As regulatory agencies and the media keep the focus on medical error and the dangers inherent in seeking healthcare services, healthcare workers, their organizations, and most importantly their customers-the patient and the patient's family-are well aware of the dangers associated with being sick. My experience has been that the strategies recommended to prevent medical error emphasize the providers' role. The need to involve the patient is overlooked. The contributors to this concise volume range from Spath, a health information management expert with a broad base of experience in the healthcare industry, to nurses, attorneys, and physicians. The patient's perspective is integrated with quotes from interviews interspersed in the text. A major theme is that patient safety is a team effort, and therefore the patient must be actively involved as a part of the team. The importance of effective communication is also emphasized as an essential tool to reduce errors in the healthcare arena.

Spath's work makes the reader more aware of how making patient-centered care a reality in practice could actually support ongoing efforts to decrease the incidence of medical errors. Strategies are outlined with useful tools offered to assist healthcare providers to make the shift from the historic, paternalistic view to a collaborative model and overcome barriers that exclude patients. The recognition that these barriers not only originate from the providers' side but also may require determining when the patient is ready to become involved is discussed in the chapter "Engaging Patients in Safety: Barriers and Solutions." Another chapter, "Creating Opportunities for Patient Involvement in Error Prevention," emphasizes the need for an organizational commitment to make the necessary culture change. This chapter also reiterates the importance of understanding the patient's perspective and of using effective communication to involve patients in their care. The legal impact of increased disclosure offers attorneys' view about the potential liability issues related to more open communication with patients. Their conclusion is that "partnering" with patients could decrease medical error and the incidence of litigation if thoughtfully implemented.

Overall, this book provides an intriguing look at patient safety. References are provided for each chapter but these are somewhat repetitious at times and limited in scope. References involving research that supports the premise that patient involvement will decrease medical error would enhance the text. The samples of tools provided and the Resource List included at the end of the book should assist healthcare providers to meet the challenge Spath and contributors pose and begin the process of creating partnerships where patients are considered true team members. Then healthcare providers, healthcare organizations, and patients may achieve the desired outcomes and make patient safety the expectation, not the exception.

PATIENT SAFETY: PRINCIPLES AND PRACTICE

Byers, Jacqueline F., and White, Susan V., Editors. Springer Publishing Company, Inc.,New York, 2004. 563 pages, ISBN 0-8261-3346-0, hardcover, $89.95.

Since the 2000 publication ofthe Institute of Medicine's (IOM)landmark report concerning healthcare errors and their effects on patients,the concern for patient safety has become an ever more important and more openly discussed issue. Additional IOM reports, the development of national patient safety goals, and the work of many private and governmental agencies over the course of the last decade plus have resulted in the current focus on safety and the human and economic costs of unsafe practice within healthcare institutions. This book, Patient Safety: Principles and Practice, provides the readerwith the theory, practical tools, and practice application exemplars needed to create comprehensive safety programs.

Byers and White divide the book into two sections: an overview ofconcepts and principles related to the occurrence of errors and a series of actual examples of safety program strategies. The first section includes a lengthy discussion of the Plan-Do-Study-Act (PDSA)model of quality improvement and its relationship to healthcare systems and processes. For a novice practitioner, this particular discussion is useful; however, for experienced nurses or nurse leaders and managers, this is most likely a review of expected quality monitoring. The authors also discuss a number of important principles, which when applied to practice can reduce medical errors and a number of tools and techniques to enhance decisions concerning patient safety. Again, some of these-runcharts, Pareto diagrams, root cause analysis-may be old hat to some readers, but the presentation here is straight forward and includes easily understood examples.

Evidence-based practice is integrated into the section on principles as a strategy for providing safe, effective, and efficient care. Included are appraisal tools to assist practitioners in the review and application of research evidence. These should enable even novicesto evaluate the evidence they consider using. The section on principle sends with a concise look atthe role of consumers, patients,and other purchasers of healthcare, nurse staffing levels, and workculture in providing safety. For each of these, the authors present strong, well-supported arguments about the potential negative impactof each, as well as strategies to make positive changes for safer outcomes. Perhaps the most useful part of each chapter is the extensive list of Web and print resources available to help the reader develop a unique safety program for his or her work place.

The second section of the book provides the reader with population and specialty-specific guides topatient safety. Included are chapters that focus on pediatric and elderly populations, acute, critical and ambulatory care, and behavioralhealth. These clinical examples allow the reader to visualize patient safety strategies that address unique patient needs in specific settings. General principles and concepts are applied to special populations so the reader can compare one setting to another and evaluate the similarities and potential differences in implementing a continuum of safe care. Again,these chapters include excellent references and sample tools to guide the reader's planning.

Overall, this book offers the reader a comprehensive overview of patient safety and the conceptualand clinical strategies necessary to achieve safety goals. Despite its length, the language is easily understood, examples and case studies provide useful illustrations of safety program implementation, and the references, resources,and glossary are excellent. The book would be a positive additionto a nursing division library, although its multidisciplinary focus makes it appropriate for any healthcare professional.