A Pilot Program Takes Flight The North Carolina Practitioner Remediation and Enhancement Partnership Experience
Julia L. George RN, MSN
Mary P. "Polly" Johnson RN, MSN

$7.95 		JONA's Healthcare Law, Ethics, and Regulation
December 2004 
Volume 6  Number 4
Pages 100 - 104
 
  PDF Version Available!

ABSTRACT
Outline

  • Problem

  • Background

  • Introduction

  • The North Carolina Experience

  • Pilot Implementation

  • Methodology

  • Results

  • Implications

  • Acknowledgments

  • REFERENCES

    • Problem

    After the publication of the 1999 Institute of Medicine report, 'To Err is Human: Building a Safer Health System,' the public became alarmingly aware that medical errors result in numerous casualties and create enormous risks to patient safety. 1 The Institute of Medicine report found that most errors resulted from flaws in systems, not from individual recklessness. The report recommended that organizations encourage reporting of errors through nonpunitive systems and shift their focus from punishing past errors to preventing future errors. 2

    Historically, healthcare systems have viewed human error within a culture of 'blame,' expecting perfection from practitioners and blaming individuals rather than examining situations when errors occurred. Additionally, when individuals who made errors were reported to regulatory boards, there were no models to guide regulators in evaluating contributing factors and examining the severity of errors before determining consequences. An honest error could be treated as blameworthy as an intentional deviation from standards. This type of regulation reinforced the practice of looking at human error as a personal failing and limited the opportunity to learn from errors. Consequently, practice errors were often not reported openly to boards for fear of punitive actions. Regulators recognized that open reporting could only occur if boards supported practice remediation and began to facilitate (rather than possibly obstruct) candid discussion and learning.

    Background

    Human error has been defined as the failure of planned actions to achieve the desired ...

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