Streams

Beyond the Checklist: Making Medicine Safer

Wednesday, April 24, 2013

The U.S. healthcare system is now spending many millions of dollars to improve "patient safety" and "inter-professional practice." Yet every year an estimated 100,000 patients are still affected by preventable medical errors or infections. Suzanne Gordon and Patrick Mendenhall look at how health care providers can reduce medical errors and injuries. In Beyond the Checklist: What Else Health Care Can Learn from Aviation Teamwork and Safety, they show that lives could be saved and patient care enhanced if hospitals adapted relevant lessons of aviation safety and teamwork.

Guests:

Suzanne Gordon and Patrick Mendenhall

Comments [11]

MD from Roslyn from Roslyn, NY


St. Francis Hospital in Roslyn was one of the first medical facilities in the region to use LifeWings, which is based on an aviation-safety initiative known as crew resource management (CRM). We introduced the program to enhance communication amongst our staff in our ORs. It has been such a success that we are expanding CRM to all of our clinical departments thanks to a grant from the LuEsther T. Mertz Charitable Trust. Like crews in the cockpit of a plane, our medical teams are trained to put safety above all else.

-Jack Soterakis, M.D.
SVP, Medical Affairs & Medical Director

Jul. 10 2013 04:53 PM
TF01 from nyc

Nick,
I obviously don't know anything about your son's diagnosis or indication for surgery.

But I would urge you to have the surgeon explain clearly the answers to these questions.

If you don't like or can't get answers to these, I would seek a second opinion.

Why is this surgery needed now and have we exhausted all non-surgical options?

What is the risk of waiting?

Why is this specific surgical procedure needed?

Are there less aggressive and/or less costly surgical procedures?

What clinical research has been done to show that this is the best treatment for this problem?

For instance are there studies comparing this surgery to non-surgical approaches?

Are there studies comparing this specific surgical procedure to other perhaps less aggressive procedures?

An article you may find interesting:
http://www.nbcnews.com/id/36197896/ns/health-health_care/t/unneeded-riskier-spinal-fusion-surgery-rise/#.UXgKPKUT_TQ

Good luck to your son.

Apr. 24 2013 12:51 PM
Tony Errichetti from Manhattan

I work in the field of patient simulations, an method to improve medical delivery. Big difference between aviation and medicine - when a flight crew makes a mistake, they die. When a medical team makes a mistake, the patient dies. The stakes and motivation to change is much lower in medicine.

Apr. 24 2013 12:39 PM
Susan from nyc

The medical field should also be more open to alternative medicine instead of demonizing it. I know more about nutrition than many doctors do.

Apr. 24 2013 12:32 PM
Nick from Putnam Valley

THERE IS NO ROOM FOR ARROGANCE IN THE OPERATING ROOM! And yet I'm sure there is plenty of it. My 27 year old son is about to have a vertebrae fusion including the installation of hardware. This is a 75 - 100 thousand dollar operation. I have spoken twice with his highly regarded Orthopedic Spine surgeon. In both conversations I experienced a distinct tone of arrogance, with some impatience and curtness thrown in. If this head surgeon brings his arrogance into the operating room HOW could any resident surgeon, nurse or other underling feel safe to question something that the surgeon is doing during the operation????? There is NO room for arrogance in the operating room.

Apr. 24 2013 12:31 PM
henry from md

Years ago I entered hospital a healthy man after a misdiagnosis of an X-ray test showed that there was apparently something 'wrong' with my kidneys. I was sent by my HMO doctor to a hospital for an IVP (Pyelogram) test. Within a day or two I developed two potentially fatal diseases (AILD-angioimmunoplasticlymphadenopathy) and a form of dangerous anemia. I survived thanks to, as a later doctor I engaged said, 'my tough constitution).
1. wrong X-ray diagnosis. 2. wrong test, even if there had been a problem with my kidneys, since I had severe asthma (Israeli Technion researches had pointed that out a year earlier).
I also found out that, at least in my case, the claim that legal representation is available on a contingency basis, proved false. I was charged $8000 initial costs to cover expenses, while my liability was open ended depending on potential future costs.

Apr. 24 2013 12:26 PM
Elliott from Bridgeport

Cockpit Resource Management - Eastern into the everglades no one was flying the plane - they realized you needed to have better organization in the cockpit. The Eastern guys were so fixated on the landing gear they never flew the plabe and ran out of fuel.

Apr. 24 2013 12:21 PM
Elliott from Bridgeport

Cockpit Resource Management - Eastern into the everglades no one was flying the plane - they realized you needed to have better organization in the cockpit. The Eastern guys were so fixated on the landing gear they never flew the plabe and ran out of fuel.

Apr. 24 2013 12:21 PM
TF01 from nyc

It's incredibly surprising that this issue doesn't get more attention.

Many of these mistakes are preventable and the solutions are known as many industries have addressed quality problems with checklists, six sigma, etc etc.

Apr. 24 2013 12:20 PM
ann from ridgefield, ct

I am a hospital pharmacist and sometimes when I am at my computer, I feel like one of the air traffic controllers in "Pushing Tin". It is a high pressure, high volume job.

Apr. 24 2013 12:18 PM
Henry from Manhattan

Note to self: Stay out of hospitals.

Apr. 24 2013 12:16 PM

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