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First, Do Less Harm: Confronting the Inconvenient Problems of Patient Safety (The Culture and Politics of Health Care Work) 1st Edition

4.8 out of 5 stars 5 customer reviews
ISBN-13: 978-0801450778
ISBN-10: 0801450772
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Editorial Reviews

Review

"Despite a decade of effort to decrease medical mistakes, progress has been painfully slow and unintended consequences have been the rule, not the exception. Two of the most innovative, iconoclastic thinkers in healthcare―Ross Koppel and Suzanne Gordon―have produced a book that tells us why, and illuminates the way forward. Their book is dramatic, honest, infuriating, surprising, and ultimately hopeful. It is a welcome contribution to the safety field, and deserves to be widely read."―Robert M. Wachter, MD, Professor and Associate Chairman, Dept. of Medicine, Chief, Division of Hospital Medicine, and Marc and Lynne Benioff Endowed Chair, University of California, San Francisco



"The question of why we are unable to make the delivery of medical care safer and better―when we know how to do it―is a critically important but often neglected piece of the conversation on health reform. Although one reason for this failure is no doubt due to economic incentives, another is related to the archaic culture of health care. The essays in this book describe a system that is piecemeal, uncoordinated, dysfunctional, and dangerous for patients―and that doesn't have to be that way."―Mary Lehman MacDonald, Director, AFT Healthcare



"First, Do Less Harm does an excellent job of detailing major system and cultural barriers confronting patient safety. Its authors discuss the important issues that we all face as frontline providers trying to deliver the best health care we can."―John Chuo, MD, MS, Children's Hospital of Philadelphia

About the Author

Ross Koppel is on the faculty of the Sociology Department and School of Medicine at the University of Pennsylvania, holds a faculty position at the RAND Corporation, and is the internal evaluator at Harvard Medical School as well as holding other professional affiliations. He is the author of several seminal publications on health IT in JAMA and other leading scientific journals.



Suzanne Gordon is coeditor of the Cornell University Press series, The Culture and Politics of Health Care Work, and was program leader of the Robert Wood Johnson-funded Nurse Manager in Action Program.

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Product Details

  • Series: The Culture and Politics of Health Care Work
  • Hardcover: 280 pages
  • Publisher: ILR Press; 1 edition (May 15, 2012)
  • Language: English
  • ISBN-10: 0801450772
  • ISBN-13: 978-0801450778
  • Product Dimensions: 6.4 x 1.2 x 9.3 inches
  • Shipping Weight: 1.2 pounds (View shipping rates and policies)
  • Average Customer Review: 4.8 out of 5 stars  See all reviews (5 customer reviews)
  • Amazon Best Sellers Rank: #667,236 in Books (See Top 100 in Books)

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Top Customer Reviews

Format: Hardcover Verified Purchase
Both LPNs and RNs need to read this book to understand that errors in their workplace are usually systems issues related to poor teamwork and communication, impractical policies, demands of the job, especially interruptions, sleep deprivation from long work hours and shift work and inadequate staffing levels. Information is also provided on what nurses can be do to create a culture of safety.

[...]
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Format: Hardcover
With a variety of essays (of uneven but mostly quite good quality), this book examines why the "patient safety movement" has had such limited and partial success. Lack of involvement of frontline personnel, top-down initiatives, and the number of core items which are "off the table" for discussion are major factors.

Items ON the table: bringing in consultants; rapid response teams; nagging people to wash their hands. OFF the table: involving frontline personnel in DESIGN of software; better staffing to permit the time for patient attention and implementation of safety initiatives; training of cleaning staff about medical hygiene and ensuring availability of ample cleaning supplies to improve hospital cleanliness. One narrative painfully recounts an institution which was very proud of instituting joint nurse/doctor rounds but at which nurses were not only ignored but were not relieved of their patient duties so they had to dart in and out of the discussion.

As mentioned above, the health IT essays detail the lack of frontline personnel in DESIGNING the software as a cause of error as well as the lack of their involvement in implementation (as they are directed simply to carry out orders to use the software). Moreover, many times nurses and physicians are excoriated if they fail to be enthusiastic about software and accused of being against new things and inflexible. When this is used as a factor in their performance evaluations and appraisal, this stifles warranted criticism even more (obviously); but this is evidently a common thing.

I was particularly pleased with the two essays on sleep deprivation, one on physicians and one on nurses.
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Format: Kindle Edition Verified Purchase
This book really captured what I experience daily as a nurse. I really appreciate the discussion of teamwork and the levels of nursing.
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Format: Kindle Edition Verified Purchase
Excellent book on issues in the current healthcare environment.
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Format: Hardcover Verified Purchase
A must read for the changing medical world. Confirmation and better understanding of why some things are happening.
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