Operational process improvement in medical TQM: a case study of human error in using devices

References

• Dahlgaard, J. J., Kristensen, K., & Kanji, G. K. (2002). Fundamentals of TQM. Cheltenham: Nelson Thornes.
   Google Scholar
• Habraken, M. M. P., Vander, S. T. W., & Leistikow, I. P. (2009). Prospective risk analysis of health care processes: A systematic evaluation of the use of HFMEA in Dutch health care. Ergonomics, 52(7), 809–819. doi: 10.1080/00140130802578563
   PubMed Web of Science ®Google Scholar
• Iida, S., Iizuka, Y., & Munechika, M. (2005). Quality glossary of terms in health care. Japanese Standards Association.
   Google Scholar
• Jin, H., Munechika, M., Sano, M., & Kaneko, M. (2013). A study on the methodology to analyse and prevent medical errors due to non-observance. Japanese Society for Quality Control, 43, 133–142.
   Google Scholar
• Landrigan, C. P., Parry, G. J., Bones, C. B., Hackbarth, A. D., Goldmann, D. A., & Sharek, P. J. (2010). Temporal trends in rates of patient harm resulting from medical care. New England Journal of Medicine, 363(22), 2124–2134. doi: 10.1056/NEJMsa1004404
   PubMed Web of Science ®Google Scholar
• Lane, R., Stanton, N. A., & Harrison, D. (2006). Applying hierarchical task analysis to medication administration errors. Applied Ergonomics, 37(5), 669–679.
   Google Scholar
• Leape, L. L., & Berwick, D. M. (2005). Five years after to err is human: What have we learned? Journal of the American Medical Association, 293(19), 2384–2390. doi: 10.1001/jama.293.19.2384
   PubMed Web of Science ®Google Scholar
• Munechika, M., Sano, M., Jin, H., & Kajihara, C. (2014). Quality management system for health care and its effectiveness. Total Quality Management & Business Excellence, 25(7–8), 889–896. doi: 10.1080/14783363.2014.906112
   Web of Science ®Google Scholar
• Nakajo, T., & Kume, K. (1984). Studies on the fool proofs in work system: Principles for fool proofs. Quality, 14(2), 20–27.
   Google Scholar
• Nakajo, T., & Kume, K. (1985). Studies of the fool proofs in work system: Assessment for fool proofs in manufacturing. Quality, 15(1), 41–50.
   Google Scholar
• Sano, M., Munechika, M., Jin, H., Kajihara, C., & Hamada, C. (2013). Analysis of medication incident for improvement of medication process. TQM & BE, 24, 859–868.
   Google Scholar
• Shekelle, P. G., Pronovost, P. J., Wachter, R. M., Taylor, S. L., Dy, S. M., Foy, R., & Hempel, S. (2011). Advancing the science of patient safety. Annals of Internal Medicine, 154(10), 693–696. doi: 10.7326/0003-4819-154-10-201105170-00011
   PubMed Web of Science ®Google Scholar
• Sophie, V., Tristan, B., & Jonathan, R. (2012). Must we get it wrong again? A simple intervention to reduce medical error. Trends in an Aesthesia and Critical Care, 2(3), 104–108. doi: 10.1016/j.tacc.2012.01.007
   Google Scholar
• Tevlin, R., Doherty, E., & Traynor, O. (2013). Improving disclosure and management of medical error – an opportunity to transform the surgeons of tomorrow. The Surgeon, 11(6), 338–343. doi: 10.1016/j.surge.2013.07.008
   PubMed Web of Science ®Google Scholar
• TQM Committee. (1998). TQM – management in the 21st century. Union of Japanese Scientists and Engineers [M], 1–30 (In Japanese).
   Google Scholar
• Vincent, C., Aylin, P., Franklin, B. D., Holmes, A., Iskander, S., Jacklin, A., & Moorthy, K. (2008). Is health care getting safer? British Medical Journal, 337, a2426. doi: 10.1136/bmj.a2426
   PubMedGoogle Scholar
• Williams, T., Szekendi, M., & Thomas, S. (2014). An analysis of patient falls and fall prevention programs across academic medical centers. Journal of Nursing Care Quality, 29(1), 19–29. doi: 10.1097/NCQ.0b013e3182a0cd19
   PubMed Web of Science ®Google Scholar
• Xie, A., & Carayon, P. A. (2015). Systematic review of human factors and ergonomics (HFE)-based healthcare system redesign for quality of care and patient safety. Ergonomics, 58(1), 33–49. doi: 10.1080/00140139.2014.959070
   PubMed Web of Science ®Google Scholar
• Yanagikawa, T. (2012). Error analysis and improving system and RCA (root cause analysis) method. Health Medical Care Science, 51(3), 142–149.
   Google Scholar