Can the Heinrich ratio be used to predict harm from medication errors?

The purpose of this study was to establish whether, for medication errors, there exists a fixed Heinrich ratio between the number of incidents which did not result in harm, the number that caused minor harm, and the number that caused serious harm. If this were the case then it would be very useful in estimating any changes in harm following an intervention. Serious harm resulting from medication errors is relatively rare, so it can take a great deal of time and resource to detect a significant change. If the Heinrich ratio exists for medication errors, then it would be possible, and far easier, to measure the much more frequent number of incidents that did not result in harm and the extent to which they changed following an intervention; any reduction in harm could be extrapolated from this

Embracing complexity: theory, cases and the future of bioethics

This paper reflects on the relationship between theory and practice in bioethics, by using various concepts drawn from debates on innovation in healthcare research—in particular debates around how best to connect up blue skies ‘basic’ research with practical innovations that can improve human lives. It argues that it is a mistake to assume that the most difficult and important questions in bioethics are the most abstract ones, and also a mistake to assume that getting clear about abstract cases will automatically be of much help in getting clear about more complex cases. It replaces this implicitly linear model with a more complex one that draws on the idea of translational research in healthcare. On the translational model, there is a continuum of cases from the most simple and abstract (thought experiments) to the most concrete and complex (real world cases). Insights need to travel in both directions along this continuum—from the more abstract to the more concrete and from the more concrete to the more abstract. The paper maps out some difficulties in moving from simpler to more complex cases, and in doing so makes recommendations about the future of bioethics

Alldred, P. (2003) Globalno razmisljanje, lokalno delovanje: price aktivistkinja, TEMIDA, 4 (6) p23-31

Anti-globalisation activists have been thoroughly demonised in the UK national media in the past year, receiving the kind of coverage usually reserved for ‘anarchists’ in the tabloid press. That is, the ‘mindless thugs’ caricature of young white men in black ‘hoodies’ intent on violence. Needless to say, this type of coverage isn’t often accompanied by any representation of protestors’ own views. In fact, when reports of protest can focus on ‘violence’, actual political grievances – the issues and the need for direct action responses to them - are ignored. Even more rare is the chance to hear women’s anger at the injustice of global capitalism and frustration at the broken promises of democracy. This piece presents the accounts of UK-based women activists against global and globalising capitalism. Contested though they are within ‘the movement’, at least the terms ‘anti-globalisation’ or ‘anti-capitalism’ say something about what is protested against, and understood together best represent the perspectives of women such as these

Interaction of Drastic and Incremental Innovations: Economic Development through Schumpterian Waves

Technological progress as a major source of economic development stems from the interaction of two types of innovations, drastic and incremental. While the former sets the fundamental pace of economic progress by redefining production possibilities as Schumpeter strongly emphasized, the latter takes the basic framework as given but pushes the production possibilities frontier outwards marginally in production practice. This paper studies the dynamic interaction and effects of these endogenously-determined innovations. Upstream firms in the model "produce" drastic innovation, which turns out brand new technology and obsolesces the existing technology used by downstream firms that specialize in final goods production. After the downstream firms adopt the new technology, they can improve it further by their incremental innovations. Economic development is shaped as successive Schumpeterian waves, where each wave begins with a great leap forward in technology which is followed by a sequence of adjustments. It is found that a rise in the success probability of future drastic innovations will discourage current efforts at drastic innovation but stimulate incremental innovations. More effort by downstream firms in incremental R&D reduces upstream firms' incentives for drastic R&D. The model ensures at least one dynamic equilibrium. In the case of multiple equilibria, an equilibrium with larger investment in drastic innovation has less expenditure on incremental innovation. The comparative static analysis shows that a reduction in the expansiveness of drastic innovation, and an increase in the total sales of downstream firms and in the significance of drastic innovation will raise (reduce) drastic (incremental) R&D efforts in stationary equilibrium.

Health Care Costs and the Arc of Innovation

Health care costs continue their inexorable rise, threatening America’s long-term fiscal stability, competitiveness, and standard of living. Over the past half-century, efforts to rein in spending have uniformly failed. In this Article, we explain why, breaking with standard accounts of regulatory and market dysfunction. We point instead to the nexus of economics, mutual empathy, and social expectations that drives medical innovation and locks in low-value technologies. We show how law reflects and reinforces this nexus and how and why health-policy-makers avert their gaze. Next, we propose to circumvent these barriers instead of surmounting them. Rather than targeting today’s excessive spending, we seek to leverage available legal tools to bend the arc of innovation, away from marginally-beneficial technology and toward high-value advances. To this end, we set forth a novel, value-based approach to pricing and patent protection—one that departs sharply from current practice by rewarding innovators in proportion to the therapeutic benefits new tests and treatments yield. Using cancer therapy as an example, we explain how emerging information technology and large troves of electronic clinical data are opening the way to near-real-time assessment of efficacy. We then show how such assessment can power ongoing adjustment of pricing and patent terms. Finally, we offer a blueprint for how laws governing health care payment and intellectual property can be tailored to realize this value-focused vision. For the reasons we lay out, the transformation of incentives we urge will both slow clinical spending growth and greatly enhance the social value that this spending yields

Spartan Daily, August 27, 2004

Volume 123, Issue 2https://scholarworks.sjsu.edu/spartandaily/10006/thumbnail.jp