Wednesday, September 23, 2009

Safe Practices to Safe Patients

Understanding the "science behind the compliance" of patient safety is important for a number of reasons. Here are the ones I find the most compelling:
  • When process changes are made, professionals who are impacted deserve to know why a change is occurring as well as what they are expected to do. (People don't roll out of bed to go to work and do things they perceive as useless, stupid, or burdensome simply because they're told "Joint Commission requires x, y, or z.....").
  • Healthcare is distinguished from other high-stakes endeavors (like aviation and nuclear power) by the number and complexity of distinct high-stakes processes that individual clinicians engage in each day and by the number of distinct high-stakes endeavors an individual patient is exposed to at each encounter. ("Just Do It!" doesn't "do it" for this crowd.)
  • The complexity of human beings is such that deviating from a standard approach to accommodate a physiologic, social, or cultural variation is often necessary. (This doesn't mean that standard operating procedures never work or shouldn't be used to form the scaffolding of patient care.) Since every eventuality cannot be tightly defined and scripted, teaching frontline clinicians the principles that inform safest practices allows them to recognize risk points when they must deviate for cause. Safety-knowledgeable clinicians are able to make adaptations that uphold core principles of safest system design. (This is another incarnation of the "teach them to fish" parable.)

I write a quarterly column about patient safety for Medscape, a robust continuing education platform. The most recent column, From Safe Practices to Safe Patients: The Evolution of a Revolution provides an overview of where the discipline of patient safety has come from and previews what's next.

It's an easy-read, no matter where you are along the journey.

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