a quantum leap for investment in patient safety - dr ：医生在病人安全投资的量子飞跃

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1、AQUANTUMLEAPFORINVESTMENTINPATIENTSAFETY:ALEGAL&MORALDUTYAPAPERBYSIMONJOHNANDMICHAELPOWERSQCSEPTEMBER2011©1681.CONTENTSCHAPTER/ParaNo.TITLEOFTHECHAPTER/ParagraphPAGENo.2.EXECUTIVESUMMARY73.INTRODUCTION144.THEEXTENTOFINJURYTOPATIENTSINENGLISHNHSHOSPITALS4.1TheEn

2、glishbenchmarkepidemiologicalevidence164.2Outcomesofmedicaladverseevents174.3ParliamentaryReliance184.4Othermedicaladverseeventsdata184.5Thesefatalitiesincontext194.6StudiesbySpecialty204.6.1HospitalAcquiredInfections214.6.2VenousThromboembolisms214.6.3Surgery2

3、24.6.4CarefortheElderly234.6.5AdverseDrugEvents264.6.6IntensiveCare274.6.7AdverseEventsinemergencydepartments284.6.8Obstetrics284.7SafetyRatingsbyDrFoster314.8Thenumberandcostofclaimsbyspecialty314.9Internationalcomparativedataforadverseevents344.10Comment355TH

4、ECAUSESOFMEDICALADVERSEEVENTS5.1Systemiccauses355.2Bupivacaineandvincristine365.3TheHealthSelectCommittee’s(“HSC”)view365.4Detailedinvestigationrare375.5InternationalClassificationofDiseasesY40-Y84385.6FailuretoLearnfrommistakes395.7Comment416THETOLERABILITYOFR

5、ISK1686.1Introduction416.2RiskinIndustry416.3Thetolerableriskofdeathtoapatientbyamedicaladverseevent457THECOSTOFMEDICALADVERSEEVENTS7.1TheDistributionoftheCostofmedicaladverseevents477.1.1-5Distributionofcosts487.2ThecostofmedicaladverseeventstoClinicians497.3T

6、hecostofMedicaladverseeventstotheNHS507.3.1ThecostofAdverseDrug-RelatedEvents(ADEs)507.3.2ThecostofadverseVenousThromboembolisms(“VTE”s)507.3.3ThecostofHospitalReadmissionstotheNHS517.3.4Thecostofhospitalacquiredinfections(HAIs)517.3.5Thecostofadditionalbedday

7、sbroughtaboutbymedicaladverseevents527.3.6Lifelongmedicaltreatmentofpermanentinjuries527.3.7LitigationClaims537.3.8TotalofcosttotheNHS557.4TheCostofmedicaladverseeventstoSociety567.4.1“TheValueofPrevention"567.4.2Thecostofmedicaladverseeventstoourbenefitsystem6

8、07.4.3Thecosttopatients617.5Conclusionandtotalcostofmedicaladverseevents638.WORLDATTENTIONTOMEDICALADVERSEEVENTS,8.1Thepatientsafetymovement658.2TheWHO’sWorldAllianceforPati