Clinical Communiqué 4/11

Clinical Communiqué Volume 6 Issue 3 September 2019

Shortcomings in the interface between humans and technological systems can lead to patient harm.

What do we need to do to keep patients safe when we explerience yet another flu season?

We discuss fixation error, the phenomenon whereby a person falls into a pattern of thinking that there is only one possible explanation.

We present an extended edition on doctor-patient communciation and discuss the polygon of patient safety.

Looking after our patients and improving the ways in which we keep them safe is only one side of the story.

In this edition, we present three cases of patients who died shortly after being assessed and discharged from an emergency department.

Thunderstorm asthma events can trigger severe asthma symptoms in susceptible individuals and potentially rapidly overwhelm health services.

The Communiqués

A resident is administered medication to which he has a known allergy leading to death prompting a review of practice and systems of care.

The Communiqués

This edition examines how the workforce issues impact resident safety and quality of care through three separate cases.

The Communiqués