September 10th, 2010 by DavedeBronkart in Better Health Network, Health Policy, Health Tips, Opinion
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The “Running A Hospital” blog has another discussion of dealing with medical error. This time, the hospital has opened up an error of its own (a “wrong side” surgery) for examination by the Open School of the Institute for Healthcare Improvement (IHI).
Sample comments:
— From IHI’s Jim Conway: “Our systems are too complex to expect merely extraordinary people to perform perfectly 100 percent of the time. We as leaders must put in place systems that support great practice by people who suffer from being human and will make mistakes.”
— From a patient who had two surgical errors in ten months: “After years of suffering through our incredibly brutal tort(ure) system I finally had the chance to talk to the surgeon. The most meaningful words he spoke were the descriptions of how badly he suffered also from the event we shared in that OR. Finally I was not alone!”
As we’ve often said, participatory medicine brings a new kind of partnership between patient and caregiver. Neither denial nor a Wall of Silence (famous book) has any place in a healthy relationship. It breaks my heart to think of the good lives that are ruined by our cultural inability to deal with honest errors in complex situations.
Yes, as Linda Kenney of MITSS mentions in a comment, some employees (in any industry) are reckless and must be weeded out. That too can be a denial issue. But first, we need open discussion.
*This blog post was originally published at e-Patients.net*
September 6th, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion, Research
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A new patient recently said he was referred to me after his last doctor had left medicine. His old doctor always looked unhappy and burned out, he noted.
Burnout affects more than half of doctors, according to researchers at the University of Rochester School of Medicine. Beyond mere job dissatisfaction, these doctors are emotionally exhausted to the point where they lose focus. They tend to be more depressed — perhaps one reason why doctors have a higher suicide rate than the general population.
While burnout can happen in any profession, the performance of stressed-out doctors can hurt someone else: Patients. Read more »
*This blog post was originally published at KevinMD.com*
July 22nd, 2010 by AndrewSchorr in Better Health Network, Health Policy, News, Opinion, Quackery Exposed, Research
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The news wasn’t good this week for women concerned about breast cancer.
First came the story that some women were diagnosed with breast cancer, very early stage, had treatment –- including disfiguring surgery -– and then found out they never had cancer in the first place. The pathologist goofed, maybe even a second pathologist also misread the biopsies.
How does this happen? Not surprisingly it comes back to the clinical experience of the doctor. Properly diagnosing breast cancer, whether through radiology scans or pathology biopsies is not always easy. And in many communities the general radiologists and pathologists just don’t have enough specialized experience. This leads to mistakes, especially when the suggestions of possible cancer are subtle and minute. Read more »
*This blog post was originally published at Andrew's Blog*
March 27th, 2010 by KevinMD in Better Health Network, Health Policy, Opinion, Research
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When nurses sign out during the end of shift, it’s done so in a quiet setting. Contrast that to medical residents — at least when I was a resident 8 years ago — where pager interruptions during sign out were the norm.
PookieMD compares the situation to the “sterile cockpit” that airline pilots enjoy:
“Pilots have the sterile cockpit–a situation in which, if the plane is below 10,000 feet, only conversation directly relevant to flying is allowed. The rule was developed because take offs and landings are the most likely time a crash will occur, and take offs and landings occur below 10,000 feet. Simple enough, and it saves lives.”
Physicians enjoy no such luxury. Patient discussions with other doctors often take place in distracted settings, under the threat of a pager going off at any time.
Changing this, PookieMD argues, requires a cultural shift. As mentioned earlier, when nurses sign out, it’s sacred time. Doctors need something similar. Studies show that medical errors can arise during the patient hand-off to another physician. Signing out patients in an undisturbed setting may minimize the risk of poor communication, and subsequently, potential mistakes. “Page early and often needs to be replaced with ‘page urgently when appropriate,’” writes PookieMD.
Let’s see if hospital administrators have the courage to make this happen.
*This blog post was originally published at KevinMD.com*
November 23rd, 2009 by EvanFalchukJD in Better Health Network, Health Policy, News, Opinion
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There is a disturbing story in the Hartford Courant (via the WSJ Health Blog) on how Connecticut state lawmakers have helped hospitals keep medical mistakes secret from the public. It’s true:
The legislature in 2002 ordered hospitals to disclose all serious patient injuries “associated with medical management.” But after the first reports were made public, hospital lobbyists persuaded lawmakers to rewrite the statute in 2004, limiting the kinds of adverse events that must be divulged, and promising to keep reports secret unless they led to an investigation.
What happened next is predictable. According to the Courant, public access to data about hospital adverse events dropped by 90%. Read more »
*This blog post was originally published at See First Blog*
