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Using interdisciplinary shared governance and patient rounds to increase patient safety.

Article Excerpt
Medical errors and near misses have become a pressing issue in the health care field. According to the Institute of Medicine (IOM) (2000), 44,000 to 98,000 deaths occur annually as a result of medical errors, making them the fifth leading cause of death in the United States and costing organizations $29 billion annually. Organizations incur costs for near misses and medical errors in the form of litigation and settlements, transferring patients to areas with higher levels of care, and advertising to recover from "bad press" (Morath & Turnball, 2005). The IOM (2000) indicated that research has demonstrated errors as due, not to an individual's actions, but rather to a breakdown in the system's processes.

Similarly, the Challenger explosion was the result of foreseeable systems errors which were not corrected and led to disastrous events (IOM, 2004). Morath and Turnball (2005) tell how a physician found aviation industry near misses kept recurring and were not addressed until fatal errors occurred. The initial studies conducted in conjunction with NASA explored root causes of near misses and errors in aviation and found many shortcomings in the system (Morath & Turnball, 2005; Powell & Hill, 2006). Taking a cue from the aviation industry, health

care leaders have begun to employ crew resource management to perform similar root cause analyses on near misses and adverse drug events (LifeWings, 2005). Crew resource management, a concept started by NASA, the Federal Aviation Administration, the National Transportation Safety Board, and representatives from several airlines, stress effective use of teamwork, communication, and accountability to counter measure errors. If an error or potential error occurs, a regression analysis is performed (Donchin et al., 2003; Grogan et al., 2004;...

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