Wednesday, November 01, 2006

Medical traffic controllers?

…Kate Murphy, writing in the NYT (Oct 31, 2006), says some ERs are consulting with pilots about how to run their ERs more efficiently and safely.

…They are interested in how the aviation industry has worked to prevent accidents.

…Communication protocols, checklists, and briefings—all can be borrowed from the airport.

…Almost 100,000 people die each year from preventable medical errors. Others get the wrong limb removed or some other pathetic screwup.

…Such mistakes are a failure of communication and leadership, not of a shortage of money.

…In the operating room, the surgeon is often the boss and people defer. In the cockpit, the crew confers rather than defers.

…Aviation people are taught to recognize human factors such as fatigue, they listen, they resolve conflicts.

…Pilots also practice in simulators and have annual competency and fitness reviews.

…Then after all this, they are getting their salaries and benefits cut and must make money consulting with hospitals.

…Still, that can’t be a bad thing overall.

…Pilots and physicians tend to be skilled and Type A. They rely on technology.

…As one dean at Stanford pointed out, “Both (jobs) involve hours of boredom punctuated by moments of sheer terror.”

…Still, some docs think the two professions differ in important ways. Aviation errors, they say, are easier to attribute to someone. The doctors fear for their licenses and standing, which causes them to downplay events.

…Trying to equate the two in terms of changing ER procedures can result in bad training, one doctor said.

…Or rather, he said, “Appallingly bad.”

…Checklists and debriefings seem to hold promise, though.

…One surgeon dissed the lists in this article as “lame and weak,” but an anesthesiologist said checklists were catching problems everyday.

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