From the perspective of a healthcare administrator, how would one promote collaboration among clinical professionals and encourage physician leadership to enhance patient care with quality initiatives that reduce organizational risk and support patient safety using the Swiss Cheese Theory? Please give me examples.


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James Reason’s Swiss Cheese Theory is sometimes also called the Cumulative Act Theory. It proposes that an organization creates defenses to prevent accidents, that line up or stack next to each other. However, within each defense, there may be human weakness, which is represented by the holes in the swiss cheese. Accidents occur when the weaknesses momentarily align. A hazard would have to make it through each of the defenses to cause an accident. Reason proposes that there are four levels of failure: Organizational influences, unsafe supervision, preconditions for unsafe acts, and the unsafe acts themselves.

His theory is often applied to healthcare. Organizational influences include systems or protocols that are mandated by the organization to ensure proper care (eg. the nurse must fill out or sign this form before giving any …

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