In Health Affairs New Review of our new book First Do Less Harm

People reading this blog might be interested in Janet Corrigan’s review of our book First Do Less Harm: Confronting the Inconvenient Problems of Patient Safety that just appeared in Health Affairs.  Health Affairs November 6, 2012.  Here are some excerpts.

“The disappointing state of patient safety in many of America’s health care institutions is chronicled in First, Do Less Harm: Confronting the Inconvenient Problems of Patient Safety. This edited volume brings together voices involved in the patient safety sphere: representatives of the medical, nursing, and pharmacy professions and experts in health care management, research, and education—at least one of whom also writes as a patient….First, Do Less Harm is well written and thought provoking and does a fine job of focusing overdue attention on some of the most challenging aspects of patient safety within health care organizations.”


“A central premise in First, Do Less Harm is that making major strides in creating a safe health care environment for both patients and workers will require tackling, as the book’s subtitle indicates, some of the more “inconvenient” problems of patient safety—ones that involve fundamental changes in culture and in human behavior and interactions. But it will be hard.”

“In a particularly insightful analysis, in the chapter titled “On Teams, Teamwork, and Team Intelligence,” Gordon captures the inherent tension between professionalism, which establishes rigid intraprofessional and interprofessional hierarchies, and the pursuit of teamwork, which is critical to safety and calls for cooperation and coordination: “Each time a profession or a professional plants a stake in the ground of patient care, it seems to separate that profession or professional from others with whom that professional should be able to work collaboratively.”


“Yet another consequence of this “toxic hierarchy,” described by Gordon, is that many institutions involved in the patient safety movement have failed to constructively engage front-line workers in safety initiatives—and the resulting worker anger is palpable….The fact that many health care institutions fail to create a culture that engages workers at all levels in the pursuit of safety is particularly disconcerting given the extraordinary pace of change in the health care delivery system.”

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