GLOSSARY FOR PATIENT SAFETY

accident—an unplanned, unpredictable, undesired random event, that can lead to injury or death. This term
should not be used in patient safety research or practice. If an event is truly unpredictable or random, it
cannot be prevented. Community Medical Foundation for Patient Safety purposely avoids the terms
“accident” or “accidental”; a suggested term is “nonintentional”.

advance healthcare directives—a list of specific instructions on the kind of care a person would like to
have if a person become unable to make medical decisions.

adverse drug effect (ADE)—an unplanned and unwanted result of a drug given to a patient that causes
harm or could cause harm.

adverse effects—an unplanned and unwanted result of treatment or therapy that causes harm or could
cause harm.

adverse event–-an observed harm to someone that resulted from a medical practice; also called medical
adverse event.

alternative therapy—any form of treatment or interventions outside the standard medical practice, such as
meditation, accupuncture, massage, herbal therapy, or oriental medicine.

best practice—the most optimal procedures that promote patient safety and quality healthcare.

blunt end (sharp end)–-the point in direct contact with vulnerable parts of the system; in healthcare, this
would include individuals such as surgeons, anesthetists, and nurses.

close call--an observed event that could have harmed a patient.

Community of Competence™–-a framework and a method to describe, assess, and combine separate
strengths and unique core competencies of individuals, groups, and organizations into a meaningful
whole to accomplish a specific purpose or reach a goal.

competency—the recognized knowledge and skill to perform a procedure or task.

complementary care—any therapy or service that is recommended to enhance standard medical care, such
as support groups, spirituality, and massage therapy.

comprehensive medicine-- the practice of medicine that includes all the patient’s physical, mental,
emotional, and spiritual dimensions—a person’s whole body and mind; also called integrated medicine or
holistic medicine.

do-not-resuscitate (DNR) order—an advance directive for healthcare that tells a doctor that the patient
does not want to be resuscitated or revived if the patient’s heart stops or the patient stops breathing.

drug interaction—a process in which the effect of one drug interferes with the effect of another drug or food,
and may cause an adverse drug effect.

durable power of attorney for healthcare—see medical power of attorney.

culture of safety--a healthcare or home environment that promotes and keeps a patient safe from harm or
unintended, adverse events or medical errors.

evidence-based medicine—medical knowledge and practice based on the best available clinical and
scientific studies and review.
healthcare team---a cohesive group of healthcare providers directly involved in a patient’s medical care; this
team also has the patient at the center.

health literacy—what a person knows about his or her own health and health in general that can be applied
to the person’s well being, his or her role in the healthcare team, and his or her safety as a patient.

iatrogenic—induced inadvertently by a physician or by medical treatment or diagnostic procedures, such as

an iatrogenic injury.

informed consent—an agreement a patient signs to receive treatment, therapy, clinical test, or participate in
a clinical study, after the patient understands the risks and benefits of the treatment, therapy, test, and
study.

latent failure – delayed-action consequences of decisions taken in the level of the organization or system;
the safety effects of this type of failure may lie dormant for a very long time.

living will—one type of advance healthcare directive that only comes into effect when a patient is terminally
ill—the patient has less than six months to live—and lists his or her wishes to withhold or withdraw
treatment to keep him or her alive, manage pain, and other wishes, such as donation of organs and
tissues. A living will does not allow the patient to select someone to make decisions for him or her.

medical power of attorney—one type of advance directive for healthcare that gives authority to someone
the patient trusts to make medical decisions for him or her when the patient is unconscious or unable to
make those decisions.

medical error—a failure of the healthcare system or practitioner to complete a planned action as intended
thus causing harm or potential harm.

medical misadventure (also therapeutic or surgical misadventure)—a medical adverse event; a medical
error
©
My Medical Journal —a safety tool and handbook to record all your important medical information,
including emergency contacts, medical and family history, list of medications, health symptoms, and
appointments. Visit www.communityofcompetence.com for more details.

nosocomial—originating or taking place in the hospital

over-the-counter—any drug that anyone can purchase without a doctor’s prescription

patient—any individual who has been diagnosed and determined by a physician or an authority with similar
medical credentials to be ill or injured.

patient advocate—a trusted person who has the patient’s safety and well being in mind when the patient
goes to a medical appointment or stays at a hospital.

patient-centered medicine—a medical practice that focuses on the patient’s health, medical condition,
concerns, beliefs, and values.

patient rights--a list of basic rights to reasonable, respectful, fair and equitable treatment and care,
including confidentiality and privacy regarding access to medical records and information, right to resolve
conflicts and have legal representation.

patient safety – an aspect and goal of the healthcare system and medical care that keep a patient free from
harm.
©
Patient Safety Checklist —a safety tool that contains a list of important reminders and actions to help a
patient stay safe, such as how to prepare for a medical appointment or prevent a fall at home. Go to
 Education and Resources/Patient Safety Products for a free copy of this Checklist.

pharming—slang term for practice of grabbing a handful of prescription drugs and swallowing some or all of
them, usually applied to young people who take pills from the family medicine cabinet and distributing
them at school or a party. This illegal practice is considered drug trafficking and dealing; taking
prescription drugs without a doctor’s approval and supervision is always dangerous and sometimes fatal.

precautionary principle—a concept and practice based on prevention and commitment to measures that
prevent consequences from an action, even if those consequences are unknown. These consequences
are judged to have some potential for major or irreversible negative impact; therefore, it is better to avoid
that action. This principle is applied in an active sense, through the idea of "preventative anticipation" or
a willingness to take action in advance of scientific evidence of the need for the proposed action on the
grounds that further delay will prove ultimately most costly to society and nature, and, in the longer term,
selfish and unfair to future generations.

prevention—the espoused goal of medicine to promote health, preserve health, restore health, and
minimize suffering and distress.

preventative anticipation—a concept and belief founded on the purpose of taking actions to prevent
negative consequences in the future, often without proof of scientific evidence of the need of those
actions and on the basis that further delay will prove costly to the individual, society, and nature.

registry—in public health, the systematic collection of information concerning specific health cases (register)
of interest.

safety reporting system—any systematic method or program to collect information about hazardous
conditions or events.

side effects—see adverse effects; usually associated with the effects of a drug.

surveillance—the continuous collection of information, analysis, interpretation, and feedback to observe

patterns and trends in time, place and persons; a safety reporting system is considered a type of
surveillance.

system—the combination and interaction of individual parts, interconnections and purpose; a system can
range in size from small, like a physician’s office (micro-system) to large, like the healthcare system
(macro-system). The power of systems lies in the way separate parts are integrated to fulfill a specific or
common purpose. The healthcare system of the U.S. consists of hospitals, clinics, pharmacies,
laboratories, and ancillary support groups that are interconnected through the flow of patients and
information to provide healthcare to patients.

systems thinking—the application of “system theory” and “system approach” to a given problem; the
concept of understanding the separate parts of the system, evaluating the parts and their
interconnections, and applying their specific and common purposes in a holistic way to increase the
overall function and performance of the system.

taxonomy—a method and system to classify medical errors by category of nature of the event, causation,
severity, and consequences.

unused and expired medicines (UEM)—over-the-counter or prescription medications that are kept beyond
their expiration date or not consumed within their therapeutic (prescribed) time period; these medicines
become a patient safety hazard.

Unused and Expired Medicines Registry (UEMR)—a national database created by Community Medical
Foundation for Patient Safety to collect information about unused and expired medicine in the home; the
Registry is used primarily for research toward understanding the dangers of unwanted medicine and to
develop a systematic program to safely collect and dispose of these medicine.