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Arch Hellen Med, 35(1), January-February 2018, 29-43


Errors are human (part I):
The contemporary approach to medical error etiology redefines the limits of personal ability

M.L. Tsantidou,1 T. Adamakidou2
1Public Health Physician, Public Health Directorate, Ministry of Health, Athens,
2Department of Nursing, Laboratory of Nursing Rehabilitation of the Chronically Ill, Technological Educational Institute of Athens, Athens, Greece

Medical error has significant effects on the health of patients and the efficiency of health systems and in recent decades its etiology has attracted the interest of the scientific community. International health organizations have incorporated the contemporary scientific approach towards medical error in their efforts to improve health systems. This is the first in a series of two reviews addressing the etiology and prevention of medical error. PubMed and Google Scholar electronic databases were searched to identify primary investigations reported in the English language examining systemic factors related to patient safety threats in hospitals, that used the World Health Organization Glossary of Patient Safety Concepts and References. Review of a total of 39 studies demonstrated that medical error and complications of medical procedures in hospital patients are related to a variety of health care provision factors. These include the physical environment and technological equipment, teamwork and communication, the tasks, workload and working hours of the personnel, protocols and procedures, leadership and management skills of surgeons, the nurses/patient ratio, the educational level of nurses, the ratio of other personnel per patient, hospital patient volume and management practices. According to the contemporary human factors approach, these factors constitute the basis from which medical errors derive. This new systemic approach to error focuses on the organizational framework that affects working conditions and on which the prevention of errors and diminution of their results depend. Its adoption by Greece's medical community would result in conservation of significant economic resources and, even more important, reduction in deaths due to medical errors.

Key words: Complications, Human factors, Medical error, Patient safety, Systemic factor.

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