Blunt End:
The "blunt end" refers to the many layers of the health care system not in direct contact with patients, but which influence the personnel and equipment at the “sharp end” who do contact patients. The blunt end thus consists of those who set policy, manage health care institutions, design medical devices, and other people and forces, which, though removed in time and space from direct patient care, nonetheless affect how care is delivered.
Thus, an error programming an intravenous pump would represent a problem at the sharp end, while the institution’s decision to use multiple different types of infusion pumps, making programming errors more likely, would represent a problem at the blunt end.
The terminology of “sharp” and “blunt” ends corresponds roughly to “active failures” and “latent conditions.”
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