High reliability perinatal units: An approach to the prevention of patient injury and medical malpractice claims

Authors

  • G. Eric Knox MD,

    Director, Professor
    1. Medical Director, MMI Companies Inc. Deerfield, IL
    2. Perinatal Center, Abbott-Northwestern Hospital, Minneapolis, MN
    3. Department of Obstetrics and Gynecology, University of Minnesota, Minneapolis, MN
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  • Kathleen Rice Simpson PHD, RNC,

    1. Perinatal Clinical Nurse Specialist, Women and Children's Care Center, St. John's Mercy Medical Center, St. Louis, MO
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  • Thomas J. Garite MD

    Professor And Chairman
    1. Department of Obstetrics and Gynecology, University of California, Irvine
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Abstract

Perinatal units differ in their ability to prevent patient injury and medical malpractice litigation. Obstetrical units with favorable performance are distinguished by common organizational and clinical features. Organizationally, they resemble what behavioral scientists define as “high-reliability organizations” (i.e., the ability to operate technologically complex systems essentially without error over long periods). Clinically, practices are based on nationally recognized guidelines and/or an operational philosophy of “safety first.” These organizational and clinical features are described so that physicians, nurses, and administrators might view their own clinical environments in the context of this perspective.

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