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dc.contributor.authorEnglish, Mike
dc.contributor.authorOgola, Muthoni
dc.contributor.authorAluvaala, Jalemba
dc.contributor.authorGicheha, Edith
dc.contributor.authorIrimu, Grace
dc.contributor.authorMcKnight, Jacob
dc.contributor.authorVincent, Charles A
dc.identifier.citationEnglish M, Ogola M, Aluvaala J, Gicheha E, Irimu G, McKnight J, Vincent CA. First do no harm: practitioners' ability to 'diagnose' system weaknesses and improve safety is a critical initial step in improving care quality. Arch Dis Child. 2021 Apr;106(4):326-332. doi: 10.1136/archdischild-2020-320630. Epub 2020 Dec 23. PMID: 33361068; PMCID: PMC7982941. Foen_US
dc.description.abstractHealthcare systems across the world and especially those in low-resource settings (LRS) are under pressure and one of the first priorities must be to prevent any harm done while trying to deliver care. Health care workers, especially department leaders, need the diagnostic abilities to identify local safety concerns and design actions that benefit their patients. We draw on concepts from the safety sciences that are less well-known than mainstream quality improvement techniques in LRS. We use these to illustrate how to analyse the complex interactions between resources and tools, the organisation of tasks and the norms that may govern behaviours, together with the strengths and vulnerabilities of systems. All interact to influence care and outcomes. To employ these techniques leaders will need to focus on the best attainable standards of care, build trust and shift away from the blame culture that undermines improvement. Health worker education should include development of the technical and relational skills needed to perform these system diagnostic roles. Some safety challenges need leadership from professional associations to provide important resources, peer support and mentorship to sustain safety work.en_US
dc.publisherUniversity of Nairobien_US
dc.rightsAttribution-NonCommercial-NoDerivs 3.0 United States*
dc.subjectdata collection; health services research; neonatology; nursing care.en_US
dc.titleFirst do no harm: practitioners' ability to 'diagnose' system weaknesses and improve safety is a critical initial step in improving care qualityen_US

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Except where otherwise noted, this item's license is described as Attribution-NonCommercial-NoDerivs 3.0 United States