Download Patient-Centred Medicine in Transition: The Heart of the by Alan Bleakley PDF

By Alan Bleakley

This e-book demanding situations useful types for extra aesthetic and moral versions, the place conversation is grounded in values structures of cultures. right here, communique is taken care of as a disbursed phenomenon related to networks of folks, actions and artifacts, and extends past doctor-patient relationships to operating in and throughout groups round sufferers. the aim of the ebook is to stimulate brooding about how sufferer care and security should be greater via a spotlight upon the ‘non-technical’ paintings of medical professionals – interpersonal communique, teamwork and scenario wisdom in groups. the point of interest is then no longer at the character of the health care professional, yet at the dynamics of relationships which shape medical professionals’ a number of identities.

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This remark is understandable but misplaced. Carlisle opposes the science of medicine and the art of care, where these practices should not have been opposed in the first place and can be readily reconciled. ‘Science’ is also an art, having a wide aesthetic brief. Science can be beautiful, imaginative, and well designed and introduces both complexity and uncertainty. Indeed, as contemporary medicine becomes increasingly complex, so it must draw on complexity theory to understand the relationship between science theory and application.

Doctors continue to reinforce hierarchies, characteristically viewing ‘teamwork as a form in which nurses (are) subordinate’ (Xyrichis & Ream, 2008, p. 236). ‘Accepting hierarchy’ has been described as one of the key aspects to the hidden curriculum in medical education (Lempp & Seale, 2004). Transition from high-risk to high-reliability medicine requires culture change, a transformation of values and institutional structures—in short, a democratizing of medical culture. The iatrogenic effects of poor communication between colleagues, and between doctors and patients, may be due to the primacy of an interrogative, rather than a collaborative, model.

Xyrichis and Ream (2008, p. 232) suggested that an estimated ‘70–80 % of health-care errors are caused by human factors associated with poor team communication and understanding’ and that 50 % of such error could be avoided through improving team-based communication. The IOM (1999) study had estimated that 72 % of hospital deaths due to medical errors were grounded An Epidemic of Medicine’s Own Making 23 in communication errors, and a 2004 US study of 2,455 patient safety events concluded that 70 % were the result of systems-based miscommunications (JCAHO, 2004), where the basic system is the clinical team.

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