LEADER 01255nam2 2200265 i 450 001 SUN0069878 005 20160201095420.643 100 $a20090505d1973 |0itac50 ba 101 $aita 102 $aIT 105 $a|||| ||||| 200 1 $aˆ<<‰Discorsi parlamentari>> 1$fFrancesco S. Nitti 210 $aRoma$cGrafica editrice romana$d1973 215 $aXX, 459 p.$d27 cm. 461 1$1001SUN0069877$12001 $aDiscorsi parlamentari$epubblicati per deliberazione della camera dei deputati$fdi Francesco S. Nitti$v1$1210 $aRoma$cGrafica editrice romana$1215 $avolumi$d27 cm. 606 $aDiritto pubblico e costituzionale italiano e comparato$2SG$3SUNC029468 620 $dRoma$3SUNL000360 700 1$aNitti$b, Francesco Saverio$f1868-1953$3SUNV010545$035791 712 $aGrafica editrice romana$3SUNV007562$4650 801 $aIT$bSOL$c20181109$gRICA 912 $aSUN0069878 950 $aUFFICIO DI BIBLIOTECA DEL DIPARTIMENTO DI SCIENZE POLITICHE JEAN MONNET$d04 CONS 6D.1.6 $e04 OM 790 995 $aUFFICIO DI BIBLIOTECA DEL DIPARTIMENTO DI SCIENZE POLITICHE JEAN MONNET$gOM$h790$kCONS 6D.1.6$oc$qa 996 $aDiscorsi parlamentari 1$91436191 997 $aUNICAMPANIA LEADER 03700oam 2200505I 450 001 9910154883303321 005 20240501170140.0 010 $a1-315-38090-0 010 $a1-4987-8117-9 024 7 $a10.1201/9781315380902 035 $a(CKB)4340000000018641 035 $a(MiAaPQ)EBC4751229 035 $a(OCoLC)964697910 035 $a(BIP)61806075 035 $a(BIP)55700818 035 $a(EXLCZ)994340000000018641 100 $a20180706h20172017 uy 0 101 0 $aeng 135 $aurcnu|||||||| 181 $2rdacontent 182 $2rdamedia 183 $2rdacarrier 200 10$aPatient safety $einvestigating and reporting serious clinical incidents /$fRussell Kelsey, MB.BS MRCGP General Practitioner. Worcestershire, UK 205 $a1st ed. 210 1$aBoca Raton :$cCRC Press,$d[2017] 210 4$d©2017 215 $a1 online resource (225 pages) $ccolor illustrations 300 $aIncludes index. 311 08$a1-4987-8116-0 327 $aIntroduction : why do we still miss appendicitis? -- RCA : background and context -- How do we recognise serious clinical incidents? -- Recognising serious incidents using the SIRT : case studies -- A culture of complaint : openness, candour, and blame -- Root cause analysis : what happened? : the evidence -- Root cause analysis : what happened? : care and service delivery problems -- Root cause analysis : understanding why -- Understanding why : system factors -- Human factors part 1 : the key to enhanced learning -- Human factors part 2 : situational awareness and high pressure environments -- Root cause -- Learning and recommendations -- Solutions design and changing cultures -- Writing reports. 330 $aAt a time of increasing regulatory scrutiny and medico-legal risk, managing serious clinical incidents within primary care has never been more important. Failure to manage appropriately can have serious consequences both for service organisations and for individuals involved. This is the first book to provide detailed guidance on how to conduct incident investigations in primary care. The concise guide: explains how to recognise a serious clinical incident, how to conduct a root cause analysis investigation, and how and when duty of candour applies covers the technical aspects of serious incident recognition and report writing includes a wealth of practical advice and 'top tips', including how to manage the common pitfalls in writing reports offers practical advice as well as some new and innovative tools to help make the RCA process easier to follow explores the all-important human factors in clinical incidents in detail, with multiple examples and worked-through cases studies as well as in-depth sample reports and analysis. This book offers a master class for anyone performing RCA and aiming to demonstrate learning and service improvement in response to serious clinical incidents. It is essential reading for any clinical or governance leads in primary care, including GP practices, 'out-of-hours', urgent care centres, prison health and NHS 111. It also offers valuable insights to any clinician who is in training or working at the coal face who wishes to understand how serious clinical are investigated and managed. 606 $aMedical errors$xPrevention 606 $aRoot cause analysis 606 $aSafety regulations 615 0$aMedical errors$xPrevention. 615 0$aRoot cause analysis. 615 0$aSafety regulations. 676 $a610.28/9 700 $aKelsey$b Russell$01241394 801 0$bFlBoTFG 801 1$bFlBoTFG 906 $aBOOK 912 $a9910154883303321 996 $aPatient safety$92879774 997 $aUNINA