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Technology as applied to patient safety: an overview
  1. Rajesh Aggarwal1,
  2. Oliver T Mytton2,
  3. Felix Greaves3,
  4. Charles Vincent1
  1. 1Division of Surgery, Department of Surgery & Cancer, Imperial College London, UK
  2. 2WHO Patient Safety, Department of Health, London, UK
  3. 3Department of Health, Richmond House, London, UK
  1. Correspondence to Mr Rajesh Aggarwal, Division of Surgery, Department of Surgery and Cancer, St Mary's Campus, Imperial College Healthcare NHS Trust, 10th Floor, Queen Elizabeth the Queen Mother Building, St Mary's Hospital, Praed Street, London W2 1NY, UK; rajesh.aggarwal{at}imperial.ac.uk

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Introduction

Patient safety is a tough problem: tough in cultural, technical, clinical and psychological terms and because of its massive scale and heterogeneity.1 Healthcare encompasses many diverse areas: the mostly routine, but sometimes highly unpredictable and hazardous world of surgery, primary care and rehabilitation where patients have established relationships with their doctors over many years, the nature of probability in preventive medicine, some highly organised and ultrasafe processes such as the management of blood products and the inherently unpredictable, constantly changing environment of emergency medicine. In all these areas, error and harm to patients are real possibilities and frequent actualities, although the nature of the harm, its causes, consequences and likely methods of prevention will differ widely according to context.2

It is important to note that an increasing awareness of medical injuries has been paralleled by the rise in technology, and the increasing complexity it causes. The number of different medications for blood pressure, the various approaches and techniques for hip surgery and the multitude of blood tests for diagnosis of infections, all provide infinitely more opportunities for things to go wrong. This is not to say that the patient safety problem is caused by technology, but rather that technology has led to a complex and confusing environment within medicine that requires support systems in order for human beings to provide the correct treatments.

Many industries have made significant advances in safety through the adoption of technology.3 Manufacturing has engaged in the reduction of human personnel through deployment of machine-based systems to produce high-quality goods. In aviation, there has been explicit acknowledgement of the potential for human error and a conscious effort to reduce error through the considered use of technology and automation.4 However, these examples are quite different. The aviation paradigm has been translated to medicine, …

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