A lot of research has been done to determine why accidents happen, and how to prevent them from occuring. It's easy to blame an individual that may have done something wrong, but that's not usually the best way to solve a systematic problem.
British psychologist James Reason suggested in his Swiss Cheese model of accident causation that catastrophic safety failures are almost never caused by isolated errors committed by individuals. Instead, most accidents result from multiple, smaller errors in environments (the holes in the cheese) with serious underlying system flaws. In this model, errors made by individuals result in disastrous consequences. Reason also emphasized that human error is inevitable, and that a systems approach can catch errors before they occur or block them from causing harm.
A study was conducted at a single site over a twelve-month period. Similarly to the experience reported in a peer-reviewed publication, patient harm was prevented and errors were captured. Additionally, a downward trend in near misses was observed, with zero reported during the last five months of the period. This suggests that the StartBox System can help healthcare facilities and providers improve their patient safety and risk profiles over time.
Kim Kramer will lead StartBox in capitalizing on its goals of mitigating risk, reducing medical liability costs and increasing healthcare operational efficiencies.
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