Patient Safety and Broken Windows Theory
One of the first rules in healthcare facilities is ensuring patient safety. Florance Nightingale (1863), this is the first rule in the hospital, not to harm the patient. ‘ ‘ Words (Florence Nightingale, Notes on Nursing: What it is, and what it is Not).
On this axis, many studies under the heading of “patient safety” in the world today are trying to eliminate or minimize the various risks faced by patients receiving health care in hospitals. These risks; It can be born from many different sources, such as diagnostic errors, drug errors, surgical errors, medical errors such as plant-induced adverse conditions, hospital infections, cases that arise during patient transfers.
Patient safety studies are provided with the measures taken by the Organization and the employees in order to prevent damage to the patient during the presentation of health care services. When these measures are not taken or inadequate, the patient’s health is becoming a threat, except for the disease.
Many studies are carried out in both the world and in our country to prevent errors during service delivery, protect the patient from possible damages due to errors and eliminate the possibility of errors. These studies are systematically revealed on the basis of both the studies of the WHO and health ministries at the macro level, as well as hospitals and clinics that offer micro-level healthcare.
Despite these macro and micro-systematic efforts, the factors that threaten the safety of the patient are able to face any deficiencies or disruption that may arise at any point in the process.
Therefore, in addition to systematic efforts, to discuss “other perspectives” for the healthy operation and protection of the system, to establish innovative new efforts in ensuring patient safety, will reinforce and solidifying security.
Cracked Windows theory
Can the broken windows theory used in different studies offer a separate perspective for health care and patient safety studies?.
Although it is a criminological theory that is aimed at committing a crime in the community, we are faced with a theory that will constitute an example of broken windows theory, patient safety efforts, or any effort that requires the healthy operation of the system. Out.
The theory of broken glass or broken windows was inspired by an experiment made by American criminal psychologist Philip Zimbardo in 1969, and anti-social behaviour on urban disorder and vandalism of other crimes is a criminological theory that points out the behaviours/symptoms and norms. Purpose The small things that deteriorated in order are changed to be organized again, and the order continues to be achieved. (https://tr.wikipedia.org/)
A section on Broken Glass article published 1982 by James Q. Wilson and George L. Kelling explains the theory (https://tr.wikipedia.org/);
“Imagine a building with a few broken windows.
If the windows weren’t repaired, someone would break a few more windows.
In the end, if the building is empty, all the windows can be broken, or they might even fire. ”
Or consider a sidewalk, thrown in a few pieces trash…
Here, some garbage accumulates over time. Recently, this garbage accumulates more. If you do not remove these garbage, the other people here and around here will start to waste their garbage all the time…
In fact, broken glass, dye-dump buildings, places in the Trash, non-working lamps, written walls, indifference, irregularities, authority Gap represents…
Application of broken windows theory on New York Metro
In theory, many different perspectives are revealed, often these theories are read with pleasure and interest, but not in practice.
However, the theory of broken windows has not been theorized and practised in 1984, when the New York Metro administration and the New York Police Department doubled crime rates.
The implementation of the theory has been started from underground, subways. It was considered as “broken window” in terms of the theory of painting of the Metro wagons that were widespread at that time. For this purpose, the cleaning of the wagons started with “repairing Windows”.
All the cars that were painted and painted were overhauled, cleaned and re-dyed. Each time, when the wagon tour completes, if there was a painted wagon, it was withdrawn from the line, not cleaned again. Thus, continuous monitoring, evaluation and improvement of the message were given.
Then he pursued petty crimes; Cars, painters, the Metro without a ticket, those who use this place as a toilet, public property damage to the rights of those who were caught in action. Many of these crimes have also been found to be sought for greater crimes and have been apprehended.
A billion passengers annually carried on the subway, thanks to the “zero tolerance” under New York, murder, injury, theft, extortion, etc. A significant decrease in the usual crimes of the times.
Can broken windows theory be applied to patient safety in hospitals?
In the example we give above, let’s put “any element and error that threatens patient safety” instead of “those who commit a crime, the Windows”. In this case, can the broken windows theory be applied for the continuous provision of patient safety in healthcare services?
For example Improper drug practices, misidentification of the patient identity, hospital infections, facility security disruptions, improper medical waste collecting, medical errors, and patient safety risks, such as small areas, in fact, are What can be seen in hospitals that increase the number of “broken windows” as they appear but are tolerated?
Perhaps the solutions of the elements that create great problems are not as complex and difficult as we thought. As we fix small things with capitalism, the net messages we provide will help the system process more efficiently.
Waiting for your feedback….