Talk:Patient safety

Wiki Education Foundation-supported course assignment

This article was the subject of a Wiki Education Foundation-supported course assignment, between 23 August 2021 and 10 December 2021. Further details are available on the course page. Student editor(s): Ashleynlogsdon.

Above undated message substituted from Template:Dashboard.wikiedu.org assignment by PrimeBOT (talk) 06:13, 17 January 2022 (UTC)

Comments

This article appears to be one of the sleeper articles on Wikipedia. Ryanjo has done a really good job with this one. Since peer review is on a backlog right now, I'll post some comments here.

The article could use a more worldwide view on the subject - most of the text concerns patient safety in the U.S. and U.K. It is also quite large and some of the sections could be trimmed and new articles can be created. Some of the external links for the patient safety organizations can also be converted to wikilinks or de-linked. Some of the images could be converted to PNG and most are missing rationale or have incorrect licenses. Otherwise, I think this article is well on its way to becoming a featured article. --Jtalledo (talk) 16:15, 6 March 2007 (UTC)

Thanks for the comments. I will try to move forward with these. Ryanjo 04:19, 7 March 2007 (UTC)

I added information about the international standard regarding medical laboratory accreditation. I also added information about the majority of errors that happen are not reported and other factors that fall under human factors for errors.

another Patient Safety resource to consider

Great article--am wondering whether you'd like to add another resource to your listing at the end, namely the Pittsburgh Regional Health Initiative (prhi.org). Founded in 1998, it's adapted Toyota Production System principles to healthcare settings in order to improve safety and quality and reduce the costs of care. It was cofounded by Paul O'Neill (please see his Wikipedia article) and Karen Wolk Feinstein, president of the Jewish Healthcare Foundation. It's a regional effort but has received national recognition from the Centers for Disease Control and Prevention as well as the Agency for Healthcare Quality and Research... as well as the Commonwealth of Pennsylvania and other large health systems in the United States. Hope this is helpful. Renuzaretsky 18:46, 8 March 2007 (UTC)RenuZaretsky in Pittsburgh

There is a companion article, Patient safety organization, which could have a link to PRHI. Ryanjo 04:11, 9 March 2007 (UTC)

Hi, I added to this page for one of my college classes, I added a section about patient safety and how it is affected by nursing burnout. Do you guys think that I should put it in a different section or is it good? Also thanks for making this article so I didn't have to create one from scratch! — Preceding unsigned comment added by 192.245.87.15 (talk) 14:26, 3 October 2022 (UTC)

Fair use rationale for Image:Toerrishuman.gif

Image:Toerrishuman.gif is being used on this article. I notice the image page specifies that the image is being used under fair use but there is no explanation or rationale as to why its use in this Wikipedia article constitutes fair use. In addition to the boilerplate fair use template, you must also write out on the image description page a specific explanation or rationale for why using this image in each article is consistent with fair use.

Please go to the image description page and edit it to include a fair use rationale. Using one of the templates at Wikipedia:Fair use rationale guideline is an easy way to insure that your image is in compliance with Wikipedia policy, but remember that you must complete the template. Do not simply insert a blank template on an image page.

If there is other fair use media, consider checking that you have specified the fair use rationale on the other images used on this page. Note that any fair use images lacking such an explanation can be deleted one week after being tagged, as described on criteria for speedy deletion. If you have any questions please ask them at the Media copyright questions page. Thank you.

BetacommandBot (talk) 06:02, 21 January 2008 (UTC)

Done Ryanjo (talk) 21:50, 9 March 2008 (UTC)

Medical ethics

The recent addition of medical ethics in the "initiatives in patient safety" section is neither detailed enough to explain how medical ethics is being applied to solve patient safety issues, nor is it referenced. I have removed this edit until some more information & references are added. The article needs to provide specific information about applying medical ethics to patient safety, rather than general or self-evident statements. Ryanjo (talk) 19:03, 17 March 2008 (UTC)

I did find an journal article pertinent to application of medical ethics to patient safety, and added it to the P4P section of the article.Ryanjo (talk) 16:25, 3 April 2008 (UTC)

Hospital accreditation

I have also removed the recently added section "Hospital Accreditation". It provides no references supporting the place of accrediting agencies as a patient safety initiative. In fact, there is evidence to the contrary [1]. Essentially, since Wikipedia is a reference work, statements in this Patient safety article should be supported by references specific to patient safety. Also, the sentence "Such accreditation can be sourced from the USA, the United Kingdom, Australia and Canada." is unclear. Ryanjo (talk) 21:10, 17 March 2008 (UTC)

Some other comments

I teach a graduate course in patient safety and I want healthcare students to be able to quickly access sources for their readings and studies. I'd like to help update this page, and related pages, on a periodical basis. From my perspective, I think this page needs to be trimmed and other pages created for specific topics. For example, my area of expertise in health information technology and organizational culutre could be separate pages with only a small paragraph on the main page. I'm newer to using Wikipedia so if I've made any errors in the section, please forgive me. P.A.P. (talk) 21:44, 27 September 2008 (UTC)

I moved this section to the bottom of the talk page since this is the preferred way to add new comment topics to Wikipedia talk pages -- a new section at the bottom of the existing sections. See WP:TPG#Layout.

Thank you for your recent updates and additions; they are are very good. As far as reducing subsections and moving detailed information to separate articles, I am all for it, as long as the main article remains comprehensive, even if more concise, and as free of jargon as possible. P4P already has a separate article Pay for performance (healthcare), but may have not been kept up as much as the P4P section in this article.

The article also needs information on initiatives in other countries, as other reviewers have commented above.

Regards, Ryanjo (talk) 15:13, 28 September 2008 (UTC)

Thank you for the new knowledge about Wikipedia talk pages. There are some many rules and manners that need to be learned that it's hard in the beginning.

I think the page is quite good. Given the general lack of concise knowledge in patient safety, I think appropriately reviewed pages on Wikipedia are great places for students (especially undergradaute and new graduate students) to start their searches on new concepts. Would you be open to having some students in my graduate patient safety course take specific sections (on a Word document) with the purpose of referencing the theoretical and research literature?

Also, I've recently completed a large review of the literature -from multiple disciplines- and discovered several ways to categorize the knowledge. I'd like to start by moving some of the technology information to the category called Health Information Technology (HIT). I have several colleagues who would help to maintain a page in this area. Your thoughts?

In the review, I found an interesting and informing body of international literature that I can post when I have some extra time over the Thanksgiving break.

You make a point that is one critique for the general site. Some of the break-off categories are not appropriate (from an expert perspective), shallow and not weel developed, while others are needed. The P4P is an excellent example of splitting not being better.

Take care and thanks for creating this page. I look forward to helping with this page. P.A.P. (talk) 18:35, 28 September 2008 (UTC)

The general principle of Wikipedia, regardless who "created" the article, is that we all "own" it, and are encouraged to make contributions. Any Wikipedia article is open to edits by anyone, or at least anyone who accepts the inevitability that someone may eventually edit their contribution!

Having said that, there are a few polite ways to make edits. Most important of all is completing the "edit summary" just above the "save page" button, so that other editors know your rationale for making edits. If you plan large deletions or other major changes, it is good form to place a new comment on the talk page (as you have done above), outlining your plans. And as many statements as possible should be referenced.

So it follows from what I've said above that it would be good for this article to have contributors from your colleagues and students. My only suggestion is that they consider becoming registered users, as you have. It is not required, and you will see many contributors are only identified by their IP addresses (ie: 86.17.249.183, etc.). However, the dynamic nature of IP addresses makes it difficult for other editors to place messages on the IP address-contributor's "user page". I have also heard that Wikipedia is considering controlling article vandalism by restricting or delaying edits made by IP address users.

As far as reorganizing the sections -- have at it! Expect a few comments and edits, in the spirit of making this article even better.

Ryanjo (talk) 02:30, 29 September 2008 (UTC)

Health Information Technology

Hello again...I'm in the process of looking at the technology section of the patient safety page and the new page that I created called Health information technology (HIT). For some reason, people are not using the new umbrella term. This might further consolidate the patient safety page with the pertinent must know safety points by shifting the background to the other area. The pages might be more systematic and hierarchical in structure –like an encyclopedia on steroids. Your thoughts? P.A.P. (talk) 03:20, 2 October 2008 (UTC)

Healthcare error

Hi. I'm beginning to work on some pages once again. The patient safety page looks fairly good but there is so much to be included in this one topic. The healthcare error area is one example. I've recently written another review paper so I will shift the healthcare error content from the PS page to the healthcare error page -leaving one concise paragraph about healthcare error on the PS page. My students tell me the large pages with a paragraph and then a link to additional knowledge are easier to navigate. I've already shifted the content but will work on the new page before condensing the PS page. Take care PatientSafetyGuru (talk) 06:14, 11 March 2009 (UTC)

WHO organizations - WAPS & PfPS

I moved the recent edits, adding the WHO organizations, to the companion article Patient safety organization. I also reduced the text on PfPS, since it was merely a copy of the linked WHO web page's description. I added a link to the WHO organizations below in the Organizations advocating patient safety subsection.

The section Initiatives in patient safety is meant to encompass broad trends, rather than individual organizations. The Patient safety organization article was broken out of this main article when several editors recognized that this article was becoming too large, and an article focused on organizations could stand on its own.

The WHO patient safety logo may pose a problem meeting Wikipedia's increasingly strict criteria for free images. The WHO website only allows unrestricted licensing for "research, private study or in a noncommercial document with limited circulation", and requires an application for other uses. This application needs to be done and approval posted promptly, or almost certainly a roving 'bot will mark the logo image for speedy deletion.

Ryanjo (talk) 14:26, 5 April 2009 (UTC)

A topic of ....

Patient meal service has been added based on the following http://scholar.google.com/scholar?as_q=patient+meal+service&num=10&btnG=Search+Scholar&as_epq=&as_oq=&as_eq=&as_occt=title&as_sauthors=&as_publication=&as_ylo=&as_yhi=&as_allsubj=all&hl=en&lr=&newwindow=1 --222.67.207.79 (talk) 08:09, 2 July 2009 (UTC)

Thanks, but -- patient meal satisfaction does not need a section in a Patient safety article. Ryanjo (talk) 00:33, 3 July 2009 (UTC)

Educational Course Sandbox

There is a group sandbox page for students who are taking NUSC 1P10 in Fall 2014.

Edits and discussion will take place there before being moved to the main article.

This page can be found here. Aw14uw (talk) 15:35, 10 September 2014 (UTC)

Course work is proceeding; we are getting ready to trial some additions in our sandbox before moving them to the main page. Our group consensus here is that we will be adding a section to the article about Communication in Patient Safety. Full details and proposed sub-sub-topics are being discussed on the sandbox talk page.

We would like any feedback that other users may offer about where this section should be added on the page? We feel it is important, so it may merit being placed above the bottom of the page. Is there a common practice for where a new section is placed on a page? --Aw14uw (talk) 16:31, 27 October 2014 (UTC)

Hi Aw14uw! Glad to hear the assignment is going well. I'm going to direct my comments here but will add a note to your sandbox talk page. I'd also like to congratulate all of you on your collaborative approach to editing this article. I know it's a part of your coursework, but I hope you will consider staying on and contributing after you graduate--we could use more editors like you.

The article as it stands on Wikipedia is in need of a bit of reorganisation as far as I can see: it consists of a long list of topics under the very broad section heading, "Causes of healthcare error". I'm going to have a bit more of a think about how it might be better organised in the future.

I agree completely that communication is tremendously important in maintaining patient safety. After all, it's one of the cornerstones of good Crew resource management which is a popular approach to safety these days. However, I don't know how well it works as a section title because it's quite broad. There are a couple of options you might like to consider:

• Adding a subsection, "Poor communication", beneath "Causes of healthcare error".
• Reorganising the current article into better sections. This might well be beyond the scope of your current assignment.

I have some comments on your sandbox edits which may be helpful to you, although I'm sure they probably don't reflect your finished product.

• Be cautious about using the 'we' voice when writing for Wikipedia--see MOS:FIRSTPERSON for details. So, "we look for someone to blame" should probably be reworded.
• There are some statements that will require a good reference (the one about fear of reprisals, for example).
• You may not be aware that there is a template for "See also" links which standardises the formatting: Template:See also. To use it, you would put this immediately under the "Safety culture" subheading: {{see also|Safety culture}}.

In any case, be bold! Best of luck, Basie (talk) 05:16, 31 October 2014 (UTC)

Our edits (the addition of a communication patient safety section) have been moved to the article page. We welcome suggestions for improvements to that section. --Aw14uw (talk) 14:58, 4 November 2014 (UTC)

Congratulations on publishing your work on Wikipedia, Aw14uw!

I've taken the liberty of doing a copy edit. This is where another editor checks for minor errors in grammar, correct tense, attempts to simplify sentence structure where possible, and aims to be concise. I've made a few changes that are usual for Wikipedia such as capitalisation in section titles and use of templates.

Here are some suggestions:

• Have a think about the quality of the sources you cite. As a medical article on Wikipedia, it's recommended that sources follow the WP:MEDRS guideline which recommends using literature review or systemic review articles. I think this is especially important when we're making claims about patient harm.
• Using the WP:Citation templates is a great way to organise your sources. I see that's already done in one of your sections, nice job.
• We have to be a bit careful to preserve a neutral point of view. We probably can't say, for example, that SBAR should always be used because there are some centres that use completely different strategies and probably do it quite successfully. If we have good evidence to support it, we could say something like, "SBAR has been used successfully in some settings to reduce misunderstandings during patient handover," and then provide a reference to support the statement. (By the way I totally agree SBAR works, but we have to stay neutral).
• The healthcare vs health care thing... I don't think there's any one right answer, so I just changed it to what's used in the article lead paragraphs ("healthcare"). Consistency is good.

Please remember that these are only my opinion. In any case, well done on your collaboration and I hope you guys stick around after your course is done. Cheers, Basie (talk) 17:25, 4 November 2014 (UTC)

Thank you Basie for your help and input to improve our communication section and ensuring it meets the good article criteria for Wikipedia! I also really appreciate that you have indicated where citations are needed in the sub-sections, and have made these additions to my section.

I appreciate your support as we are new Wikipedians, Kayleigh 23:46, 4 November 2014 (UTC) — Preceding unsigned comment added by Kt13us (talk • contribs)

Basie, your suggestions are greatly appreciated! We will make the corrections you have commented on. Feel free to continue providing us with feedback when necessary. --Tania (talk) 03:44, 5 November 2014 (UTC)

Thank you Basie. I am the students' professor. I agree with your comment about the potential to reorganize this article to provide better coherence. @Tt13lq, Kt13us, Aw14uw, and Vw13mp:, do you have any ideas for the article organization as a whole, for Basie and the other editors of this page? (I hope some of you will stick around to help with it). LynnMcCleary (talk) 22:58, 15 November 2014 (UTC)

Hey Kt13us, Vw13mp, Aw14uw, Tt13lq I have been assigned your edits to provide feedback on by our Professor. First off, I would like to say that you all have done an awesome job editing this article and adding a lot of information about communication. Well done! While reading through what you have added to the article I only noticed minor things I could provide you with some feedback on. One of Wikipedia’s criteria for a good article is to remain neutral, you have done that overall well, however there are times when words such as “always use” come up, which tend to give preference to one side over the other. Another thing I would like to point out is the use of the words “we” as Wikipedia should remain third person and not first. Otherwise, what you all added was done really well. I would like to congratulate you all for getting through this assignment! I know it’s been a tough one at times so way to go! Vr13zk (talk) 22:16, 7 November 2014 (UTC)

Congratulations on some good work here. This seems like a pretty comprehensive article. One way to take it to the next level might be to discuss the high reliability organization in healthcare. High reliability is a concept borrowed from other industries, but there is a good bit of literature in recent years on turning hospitals into HROs. EricEnfermero ^HOWDY! 13:38, 11 November 2014 (UTC)

missing important issues

One of the most common causes of error, confusing patients with each other, and the probably most important device used until now to ensure patient safety, wristbands, are not even mentioned in the article. I also wasn't able to find mention of the common error of operating on the wrong side or wrong member of a patient. --Espoo (talk) 23:02, 30 October 2014 (UTC)

Communications in patient safety

The edits you have made are good based on the good article criteria. The information was neutral, verifiable, well written, stable and covered the topic appropriately. I really like the picture that was used and how it illustrates non-verbal communication. To improve this edit I think some sentences could be reworded, as some of them were a little hard to follow. For example the sentence, “Some channels are more likely to result in communication errors than others, such as communicating through telephone or email (missing nonverbal messages which are an important element of understanding the situation)” is confusing to read. A possible change could be, “Communication channels such as the telephone or email are more likely to result in communication errors. This is because they are missing nonverbal messages, which are important to understand the context of the situation.” A little rewording will improve the flow of the paragraph a lot. The content of the article edit is great and very informative, but I noticed that only one source was used. I think the information would be more credible if a variety of sources was used, rather than just one. Finally, I liked how the section was organized and how the topic was introduced and explained in an order that was easy to follow. Other than some sentence restructuring and additional sources, I think this Wikipedia edit was well done. Good job everyone! Mh14wc (talk) 18:03, 21 November 2014 (UTC)

@Tt13lq, Kt13us, Vw13mp, and Aw14uw: I have a few comments on the communications section that has been added to this article:

• First off, as noted by other editors above, I agree with you that this is a necessary and important section for an article on patient safety.
• I do want to point out that patient safety is an article of interest to the Medicine WikiProject, as such the requirements and expectations for which sources are used and how they are used are much more stringent than on most wikipedia articles. Specifically, peer reviewed work is strongly preferred to other material and literature or systematic reviews are generally favored even among peer reviewed articles. Not all of that applies directly to the material you've added (as the article isn't making claims about drug X or disease Y) but the expectations should still be that the best possible sources will be used.
• To wit, the majority of the section relies on materials from the canadian patient safety institute--a guide for best practices and two literature reviews. None of these are problematic per se but I think that a critical reader might benefit from noting in text where the material comes from. Something as simple as saying "suggested best practices for communication between healthcare professionals and patients from the Canadian Patient Safety Institute include..." That may work well or poorly in the text, but I think it is worth exploring.

 Done An in-text reference and link to CPSI has been added -- Aw14uw (talk) 14:51, 16 November 2014 (UTC)

• I also don't want to add to your workload but there are a number of widely cited literature reviews on the topic from a medical (here, here, here (though that is focused on primary care)) and nursing (here, here, here) perspective. It is clearly not a trivial task to find, digest and summarize these works, but it might help further improve the section and allow for a critical reader to convince themselves that the article represents a good summary of the field.
• This is a minor sourcing issue, but the term I believe you're looking for with respect to "multiple cause incident analysis" is Root cause analysis (colloquially sometimes referred to as "the 5 whys"). That will help you find a much better source than this to note that there are multiple causes for particular incidents.

 DoneThese two changes have been made Aw14uw (talk) 14:24, 6 November 2014 (UTC)

• One final note. In general the tone of wikipedia articles should shy away from offering advice to readers. In some cases this is very easy to avoid--the article on bread does not contain a recipe for bread. In cases like patient safety it is much more difficult, as it is hard to explain the concept of patient safety or communications with respect to patient safety without noting where errors occur. But I think you'll find the section much improved if you move away from offering what is essentially a best practices guide for professionals to a more general summary of the history, research and impact of communications on patient safety. Happily, this is the sort of change which dovetails well with including a wider range of sources. When you can bring in material from the research, review, industry and advocate sides you'll find the resultant summary is much more neutral and straightforward and has none of the issues you get from relying too much on a single source.

Please let me know if you have any comments on the above either here or on my talk page. Adam (Wiki Ed) (talk) 22:15, 5 November 2014 (UTC)

Amazing work on the current edits made to this page. I found that the communication section added was much needed in this article and was overall a very well done contribution. I liked the way that you linked patient safety to communication between health care teams and professionals. It was also an interesting idea to add a section about communicating patient incidents after they have occurred. I agree with Adam when he says that sometimes it may be difficult to shy away from “giving advice” in your article. When I read your information, I didn’t necessarily view it as advice, more so as information and general facts about proper communication to promote patient safety but I do understand what Adam has said. I would also suggest adding a few more sources in order to make your additions more factual rather than have them slightly reflecting advice. I believe this issue falls under the Wikipedia Pillar that states that Wikipedia must be written from a neutral point of view. Other than this small issue I found that your group followed the 5 pillars of Wikipedia quite closely. Really great job so far! Tm13wg (talk) 15:18, 11 November 2014 (UTC)

Wow you guys have done a great job with the section you added to the page. It brings many important ideas to the article that it was previously lacking. First of all, I’d like to commend you guys on your excellent communication within your group. I read through the talk page on your sandbox, and you all contributed some great ideas and worked well with each other to help those ideas come together. Definitely following Wikipedia pillar that editors should treat each other with respect and civility! I agree with the comments Taylor made. With a broader range of sources, I feel like the tone of “giving advice” could be easily fixed. However, this is minor as the section overall is well done. I think it would be a good addition to your section to add in a picture. One example of a picture that could be helpful to the article would be of a health professional and patient engaging in nonverbal communication. This is something that is hard to explain with words but, as you touched on in the Effective and ineffective communication section, is crucial to patient safety in order to get the desired message across. I noticed that there was a citation needed for the last line of the Teamwork and Communication section. This citation should be found and inserted. This is a small detail, but is important in ensuring verifiability of the article. Overall though, you did an amazing job on adding an entire new section. Keep up the great work! Nicole 04:07, 12 November 2014 (UTC)

 Done A reference to CPSI has been added as requested.

Professor comments to student editors

@Tt13lq, Kt13us, Aw14uw, and Vw13mp:, I want to add my congratulations to you on your contribution to this article. You've clearly learned a lot about how communication impacts patient safety, you've been succinct in your summaries, and you're responding to feedback. You have a few recommendations from fellow editors about how to further improve the article. I hope you'll take them up on their suggestions. It would be a good idea to make a summary of changes you weren't able to respond to (so you can come back after the course is over or so other editors can act on the recommendations). Our reviews are lengthy and a lot for editors who are new to the page to wade through.LynnMcCleary (talk) 22:53, 15 November 2014 (UTC)

I would like to thank everyone for their feedback on our additions to this article! Based on the feedback we have received our edits have been oriented to improving the tone of our article (less 'giving advice' and more factual information), and adding an image for the overall appeal. I am proud of the collaborative effort our group has put in, as well as appreciative of the help we have gotten from our classmates, professor and fellow wikipedians. For anyone who is wondering, the image I have uploaded is free public domain, so hopefully it will remain posted on the Patient Safety article. The image displays a nurse using non-verbal communication to a client through facial expressions. Final changes to our communication section will be posted by tomorrow, and if you have any further suggestions please feel free to let us know!

Kayleigh 05:35, 19 November 2014 (UTC)

Specific high-impact interventions

doi:10.7326/0003-4819-158-5-201303051-00001 discusses the process of assessing a patient safety intervention and lists a number of interventions that are thought to be worthy of widespread adoption. JFW | T@lk 19:53, 9 November 2014 (UTC)

Wiki Education assignment: Technical and Scientific Communication

This article was the subject of a Wiki Education Foundation-supported course assignment, between 22 August 2022 and 9 December 2022. Further details are available on the course page. Student editor(s): Kcarson03 (article contribs).

— Assignment last updated by Kcarson03 (talk) 14:21, 21 September 2022 (UTC)