Organizational Structures, Cultures, and System Aspects of Safety in Tertiary Health Care: A Comparison with Other High Risk-Industries

Award Year:
David Gaba
Patient Safety, Healthcare Organization
Preventable accidents occur frequently in health care, especially in comparison with the rate of serious mishaps in commercial and military aviation, space flight, and nuclear power production. Dr. Gaba's systematic comparison of health care to these industries is guided by a synthesis of recent theoretical models of safety and error in complex organizations. Among the issues the project addresses are the structure of the health care industry, regulatory processes, and cultures of reliability concerning the care of hospitalized patients. The influence of malpractice litigation on safety, the connection between fatigued personnel and error in health care, and the effects of production pressure at work are also studied. By mapping features of health care to similar features of high-risk industries, Dr. Gaba formulates an integrated view of the implications for safety in health care. Project results provide recommendations for short and long-term policy changes to strengthen safety systems in health care.