Preface

Patient safety continues to be one of the most important and challenging priorities for healthcare systems around the globe. More than two decades of highintensity research and administrative, and institutional culture changes have resulted in measurable and significant improvements. Despite this, the attainment of a "zero defect" or "perfect score" patient safety environment remains an elusive target.

As our collective understanding of the importance – and the integral role – of patient safety in everyday clinical practice matures, our ability to ask increasingly more relevant clinical and safety system design questions also grows. Consequently, modern patient safety systems can hardwire process improvement into the very fabric of their day-to-day operations. This, in turn, provides us with continuous opportunities to engage in the journey to "zero defect" and ultra-safe healthcare environments.

Another essential component of the modern patient safety paradigm is the ability to approach complex events associated with often very serious morbidity and even mortality in a fashion that is objective, nonjudgmental, and constructive. The old paradigm of "assigning blame" and "moving on" has given way to the new paradigm of evidence-based, open-minded, and outcome-driven analytical group approaches. Critical thinking, open communication, and the ability of any team member to voice patient safety concerns are all central to our ability to provide clinical care of the highest quality and optimal value.

Without exception, every healthcare provider should strive to attain the mastery of key principles of clinical patient safety, with a focus not only on theoretical considerations but also on practical, everyday bedside implementations of this essential knowledge. Institutional environments continue to evolve toward interactive architectures that facilitate teamwork by way of enhanced communication skills, communal regard among all clinical and non-clinical care providers, and rigorous professionalism. Clinicians and administrators alike must openly encourage and praise behaviors that actively contribute to the establishment and maintenance of a culture of safety across our institutions. Likewise, organizations should encourage and actively support patient safety champions. Ultimately, patient safety will flourish more as a grassroots endeavor rather than as a top-down mandate.

This book is an easily accessible, practical, and problem-focused resource for healthcare practitioners looking to enhance their patient safety knowledge and related clinical and organizational skills. It is our hope that various novel approaches and new perspectives included in this book will stimulate further patient safety discussions, education, and bedside innovation across our clinics and hospitals.
