tag:blogger.com,1999:blog-32053362.post7305713391077803964..comments2024-03-29T05:39:11.334-04:00Comments on Not Running a Hospital: Sully inspires and presses for actionPaul Levyhttp://www.blogger.com/profile/17065446378970179507noreply@blogger.comBlogger10125tag:blogger.com,1999:blog-32053362.post-21521420475092761052016-01-27T20:06:21.373-05:002016-01-27T20:06:21.373-05:00Or, it's simple but not easy!Or, it's simple but not easy!Paul Levyhttps://www.blogger.com/profile/17065446378970179507noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-81432340608436567452016-01-27T19:02:57.246-05:002016-01-27T19:02:57.246-05:00There is a complex interdependence between the in...There is a complex interdependence between the individuals and the organization - external explicit rules can become over-ridden by local subliminal cultural normalization.<br />See http://onlinelibrary.wiley.com/doi/10.1111/1467-9566.12370/full for an excellent cross-cultural ethnographic study of these factors & relationships. It's not simple!Anonymoushttps://www.blogger.com/profile/16593864269998549240noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-6820761638492459572011-05-06T02:24:41.023-04:002011-05-06T02:24:41.023-04:00He is so right. It is more than checklists. It i...He is so right. It is more than checklists. It is attitudes and having the right mindset. Yet ironically the training in becoming a doctor or RN is vastly different than the military, where teamwork is literally drilled in on day one in the latter while the former values individual perseverance. Until that changes, it will be difficult to move the culture of medicine to where it should be.<br /><br />http://davisliumd.blogspot.com/2010/11/why-doctors-need-to-be-less-like-chuck.html <br /><br />-- <br />Davis Liu, MD<br />Author of Stay Healthy, Live Longer, Spend Wisely: Making Intelligent Choices in America's Healthcare System<br />(available in hardcover, Kindle, and iPad / iBooks)<br />Website: www.davisliumd.com<br />Blog: www.davisliumd.blogspot.com<br />Twitter: davisliumdDavis Liu, MDhttps://www.blogger.com/profile/15320315964654209559noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-65855809360591616262011-05-01T18:24:03.615-04:002011-05-01T18:24:03.615-04:00Thomas,
This is called "normalization of dev...Thomas,<br /><br />This is called "normalization of deviance" and was used to describe the events leading to the Challenger launch decision.Paul Levyhttps://www.blogger.com/profile/17065446378970179507noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-47302595433063348582011-05-01T15:09:59.806-04:002011-05-01T15:09:59.806-04:00In my experience as an anesthesiologist in a busy ...In my experience as an anesthesiologist in a busy metro trauma center, most errors are due to the over-confidence that comes with experience; we assume that what we're seeing is within the realms of "normal," is manageable, is benign, is an artifact, is not important in the bigger picture, etc.<br /><br />Blindness to Truth is an acquired disease.<br /><br />You can be wrong many times before it comes back to haunt you. <br /><br />As a partner of mine often notes: "It's really hard to kill someone." If it were easy, it wouldn't be for long.Thomashttps://www.blogger.com/profile/13039946349234510671noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-90844080128490240902011-05-01T15:01:12.277-04:002011-05-01T15:01:12.277-04:00As a big fan of Capt. Sully, the pilot who success...As a big fan of Capt. Sully, the pilot who successfully landed the plane on the Hudson River in the U.S., I am so glad to hear he's using his expertise to improve patient safety in hospitals.<br /><br />Great work again, Capt. Sully!Every Patient Mattershttps://www.blogger.com/profile/04413946418467061676noreply@blogger.comtag:blogger.com,1999:blog-32053362.post-34592174906740993982011-04-30T11:34:27.316-04:002011-04-30T11:34:27.316-04:00CMS and P4P are inadequate for the same reason pat...CMS and P4P are inadequate for the same reason patient satisfaction measures are inadequate. They are not timely, they are information-in rather than -out, and they are not sensitive to some of the strongest predictors of harm, such as hierarchy, siloing, and care modeled around physician interest rather than patient need. <br /><br />But I'm not sure that teaching "the science of safety" is adequate either. The tools are critical, but unlikely to be adopted wholesale if medicine does not think differently about the very definition of what physicians do. Academics need to become as hungry about data on care as they are about data in their labs. Patients, hospitals, and physician organizations have even more incentive with ACO risk contracts to improve and push new information in new ways.<br /><br />Isn't it time for MIT to start a med school? Now THAT would be disruptive innovation!Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-80755739619723113322011-04-29T12:01:08.525-04:002011-04-29T12:01:08.525-04:00I would suggest we then start focusing on these is...I would suggest we then start focusing on these issues instead of wasting providers time with the collection of worthless data and computer entries that have not been documented to increase patient safety. While the goverment and other payors seemingly want data to bring quality into the equation of payment, they seeemingly want this for free and at the expense of caregivers doing the documentation and data entry. This will only serve to divert our attention from the things we know really matter and are not likely to add to safety or quality improvements.Keithnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-1404389932042120452011-04-29T11:49:32.710-04:002011-04-29T11:49:32.710-04:00Sulley’s comment about the importance of attitude,...Sulley’s comment about the importance of attitude, behavior and teamwork as it relates to the use of checklists is extremely important. The challenge is how to get doctors, especially surgeons, to embrace this to the point where nurses, techs and other staff feel empowered to speak up without fear of retribution or reprimand if they notice something wrong especially if it’s something the doctor is doing or not doing but should be.Barry Carolnoreply@blogger.comtag:blogger.com,1999:blog-32053362.post-8200365899194041292011-04-29T05:43:37.260-04:002011-04-29T05:43:37.260-04:00What a direct and hard-hitting set of quotes from ...What a direct and hard-hitting set of quotes from him. Any one could stand alone as a wake-up call; taken together, I find they make me ashamed as a physician. Like a student caught not trying hard enough.<br />Indeed.<br /><br />nonlocal MDAnonymousnoreply@blogger.com