Medical Error - Recognition, Reporting, Managing Response, and Limiting Harm

The development of patient care checklists, crew resource management strategies, and medical simulation programs are directly patterned after aviation practices. Out-ofhospital health care, to include emergency medical services and critical care transportation, has also drawn upon the lessons learned in law enforcement and fire services. Fear of potential disciplinary action or litigation is also a major concern among prehospital providers. Similar fears exist in both medical and nursing disciplines, and are commonly stated limitations to functional error-reporting tools. Due to the pressure regarding job security and licensure maintenance, under-reporting is common. Error-prevention measures that limit harm should include development of systems that reduce reliance on individual memory, such as check lists, flow sheets, drug dosage guidelines, and printed algorithms. Improved remote access to information in archived medical records would be useful. Key elements include medical error recognition and reporting strategies, and the implementation of patient safety education and tools that empower health care providers to provide safe care.