It is by thinking less about 'bad people' and more about 'bad systems', by learning from the things that go wrong, by strengthening the systems of care and by going upstream to prevent problems that the quality and safety of care will be truly transformed.
Sir Liam Donaldson speaking on the subject 'Medical ethics: medical mistakes and complaints' for the 4th Lord Jakobovits Commemorative Lecture, Royal Free Hospital, London, 10 February 2004.
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Every antibiotic expected by a patient, every unnecessary prescription written by a doctor, every uncompleted course of antibiotics, and every inappropriate or unnecessary use in animals or agriculture is potentially signing a death warrant for a future patient.
Sir Liam Donaldson speaking about antimicrobial resistance in his 2008 Annual Report of the Chief Medical Officer, March 2009
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Sixty years after its foundation, the NHS needs to learn to apologise more often. And it needs to learn to mean it.
Sir Liam Donaldson discussing how the medical profession should respond to clinical errors, in 'Sorry is still the hardest word', Scrubbing Up, BBC, 26 February 2009
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Every time a healthcare professional touches a patient, several thousands of bacteria can be transmitted. These can be bacteria like Staphylococcus Aureus, of which Meticillin-Resistant Staphylococcus Aureus or MRSA is one of the most dangerous.
Sir Liam Donaldson talking about healthcare associated infection, in his 2006 Annual Report of the Chief Medical Officer, July 2007
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Finally, I return to the concept of respect. We must see this not as a narrow strand of professional etiquette. It must be as deep and broad as the ocean. I take a holistic view of the important principle of respect in the new world of clinical practice and health care.
Respect for patients as people goes beyond the individual relationship between health professional and patient. Respect means:
Only through embedding respect in our system at the level of the individual encounter as well as in the institutional fabric, will our health service regain its proud position as the best in the world.
Sir Liam Donaldson speaking on the subject 'Medical ethics: medical mistakes and complaints’ for the 4th Lord Jakobovits Commemorative Lecture, Royal Free Hospital, London, 10 February 2004.
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Knowledge is power, knowledge management is the use of power for good.
Sir Liam Donaldson speaking at the launch of the patient safety domain of 'QualityHealthCare.org', National Patient Safety Agency, London. 18th March 2003
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I've seen it many times - the NIIMBY effect. Not Invented In My Back Yard.
Sir Liam Donaldson speaking on 'A professional's view of patient involvement' at the Chief Nursing Officer's annual conference in Harrogate, 15th November 2001
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Good practice often spreads slowly, like treacle. We need to make it flow like mercury from one part of the NHS to another.
Sir Liam Donaldson speaking on the subject of clinical governance at the British Association for Surgery of the Knee, at the Royal Society of Medicine in London, 7th June 2001
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Returning to where I started let's make ethics a living and breathing part of our health service. Let's not see it as merely a list of seminar topics. Let's not be constrained in our thinking and approach. As I have found in thinking about the principle of respect it goes broad and it goes deep. And by exploring it and the other dilemmas and controversies in modern health care we can continue to open up the frontiers of good medical practice.
Sir Liam Donaldson speaking on 'Health care delivery: ethical dimensions' at a conference, Difficult Decisions: Ethics Support in the Delivery of Health Care, organised by Nuffield Trust, BMJ and ETHOX, London, 27 February 2001
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It is important then that discovery leads to learning and that learning leads to change. I think that in the past we have over-emphasised individual learning and downplayed the team and organisational aspects of learning.
Sir Liam Donaldson speaking on the subject of healthcare innovation at the Sixth Annual Smithkline Beecham Science Policy Symposium, at the Royal College of Pathologists,Thursday 21 October 1999
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The feature that distinguishes the best health organisations is their culture.
Sir Liam Donaldson writing in the British Medical Journal 1998; 317:61-5
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Generally, too many of the responses to complaints lacked the essential ingredients which would be regarded as mandatory in other sectors. In particular, the responses commonly failed to show a health authority's willingness to act on the results of the investigation or to offer practical advice or support to complainants.
Sir Liam Donaldson writing in Quality in Health Care 1992; 1:21-25
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Chekhov once observed that a good writer helps us to feel not just life as it is, but life as it should be. The movement for evidence based medicine offers something similar - enlightenment coupled with views of a promised land.
Sir Liam Donaldson writing in the British Medical Journal 1997; 314:615
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Policy making and management in health care badly need their own evidence based movement. This needs champions, concepts and methods, and an infrastructure in training and information management.
Sir Liam Donaldson writing in the British Medical Journal 1997; 314:615
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Patients will wish to see their concerns taken seriously, their complaint investigated, a clear explanation given, and follow-up action taken.
Sir Liam Donaldson writing in Quality in Health Care 1992; 1:21-25
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Complaints made by patients about their care received represent an important opportunity to learn lessons about possible service failures, which can then be translated into improvements in service quality.
SIr Liam Donaldson writing in Quality in Health Care 1992; 1:21-25
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Effective entry into this medical audit cycle necessitates the collection, analysis and interpretation of data on populations of patients, for comparison against standards so that an objective analysis is possible and a baseline can be set to assess subsequent change. Thus, although discussion of individual cases is an integral feature of good medical practice and may itself suggest topics for subsequent audit, it cannot drive the cyclical process, nor can it reveal the overall quality of service.
Sir Liam Donaldson writing in Journal of Public Health Medicine 1990; 12:149-51
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