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and control; and the handling and use of blood and blood products. Other traditional approaches to learning about error and how it might be prevented include morbidity and mortality conferences and autopsy.

Life Safety

Life safety refers to a set of standards for the construction and operation of buildings and the protection of patients from fire and smoke. These standards are based on the Life Safety Code, promulgated by the National Fire Prevention Association. Life safety standards that require fire alarm and detection systems are monitored and serviced routinely, that fire and smoke containment systems are in place, and that systems for transmitting alarms to the local fire department are functional. Facilities typically participate in fire and other disaster drills that help them identify weaknesses in their systems. By analogy, many other kinds of delivery-related simulations can probably help groups with differing disciplinary backgrounds learn to work cooperatively and effectively in, for example, the intensive care unit, emergency department, or operating room. The recent development of highly sophisticated operating room simulators has demonstrated their value both in teaching and for practitioners to practice recovering from crises.

Infectious Disease Surveillance, Prevention, and Control

Today, infection control covers a broad range of processes throughout the hospital. It requires epidemiological expertise and includes attention to medical devices (e.g., intravascular and alimentation devices, ventilators, equipment used for examination); the physical environment (e.g., air ducts, surfaces); surgical wound management; and carriage by employees and other health professionals.

Such infection control processes are managed by individuals who are assigned the responsibility of surveillance, reporting, and investigating outbreaks of nosocomial infections (infections acquired while in health care that are unrelated to the original condition), and putting in place and monitoring the results of processes to prevent or reduce the risk of infectious transmission. In the best systems, data from many sources within the hospital—infection control committee surveillance, length-of-stay outlier reports, operating room logs, bacteriology and pathology reports, morbidity and



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