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[Need for innovation in working with adverse events]
Birgit Viskum1, Andreas Granhof Juhl, Inge Pedersen
1Center for Kvalitet, Region Syddanmark, P.V. Tuxensvej 5, 5500 Middelfart, Denmark. birgit.viskum@dadlnet.dk
Abstract:
Patient safety has been in focus in the Danish health care for the past five years, with a mandatory reporting system for adverse events/incidents at hospitals. The incidents have been analysed with the Root Cause Analysis. This analysis is a relatively simple linear cause effect analysis, however, not suitable for the use in a complex sociotechnic health-care system. There is a need for other methods and approaches, which can reflect this complexity and focus on the future prospective prevention.
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