In order to effectively prevent patient harm, we must fully understand the different types of harm that come to patient in our care. By expanding our definition of harm beyond the legal definition of standard of care and beyond the limits of regulatory agency definitions, healthcare providers are better able to analyze causes of harm within healthcare. Outcomes which were once thought to be unpreventable are now considered unacceptable, for example, ventilator associated pneumonia. Patient Safety advocates need to expand our observations and include any event not related to the natural or expected course of the patient's illness as defined harm.
Participants will be able to:
• Implement actions that are actionable, measurable, and which hold individuals accountable
• Examine potential harm from multiple available sources ("cast a wide net")
• Diagram an integrated, transparent model for analyzing outcomes for opportunities for improvement