english.prescrire.org > Positions > Basic principles > Preventing the preventable

Theme: Basic principles

What are the tenets that underpin our approach? A scientific spirit, respect for the evidence, tempered by scepticism. Humility, empathy and unwavering devotion to the patient’s interests. Most crucial perhaps is independence.

Themes

Preventing the preventable

Analysing errors and malfunctions is one of the most direct, and most necessary, methods of achieving progress in quality of care and patient safety. Prescrire's programme "Preventing the Preventable" lets subscribers share their experiences and work out solutions, without judgement, and in total confidentiality.

When it comes to healthcare, analysis of errors and malfunctions is one of the most direct, and most necessary, routes to achieving progress in quality of care and in patient safety. However, there is much room for improvement. There are no doubt several explanations for this situation. First, it is often difficult for a healthcare practitioner to imagine that a failure or an adverse event could be the result of his or her own errors.

Even when making every effort to provide the best possible care, many personal factors can prevent an individual practitioner from taking the analysis any further: a sense of shame, certainly, sometimes a sense of being all-powerful, perhaps a fear of being stigmatised or even sanctioned, perhaps self-complacency, etc. Not to mention ignorance, or a tendency to avoid dealing with the problem, when faced with the need to care for other patients, as well as a demanding work schedule. Healthcare is also increasingly complex, involving more and more caregivers, teams, (organisation of health services, risky devices and technologies, and a false sense of security. And with these come an increasing number of opportunities for error, and the diffusion of responsibility.

But not seeking solutions to these problems and keeping silent does not protect patients: silence exposes patients to the risk of repeated adverse effects, to avoidable iatrogenic errors.

Prescrire has provided its subscribers with a way to escape from this unfortunate inertia, via its programme "Éviter l'évitable" ("Preventing the Preventable"). The programme includes: reporting and structured, in-depth analysis of errors or circumstances which might have produced errors ("near misses"), in total confidentiality; using this data, once it has been made anonymous, to share their experiences with the community of healthcare professionals who subscribe to Prescrire, and also to contribute to improved patient safety.

Who hasn't made mistakes? Isn't avoiding similar mistakes in the future some consolation for past errors? Prescrire's Preventing the Preventable's philosophy is to let subscribers share their experiences and work out solutions, without judgement, and in total confidentiality. Let us dare to talk to one another.

Source: "Sortir du silence" Rev Prescrire 2007; 27 (288): 721.