Thursday, October 1, 2009

Change of Shift is changing the world

Change of Shift is up at Emergiblog. Take a look to find out what nurses are talking about.

I included a post I wrote last Sunday about how social media (SM) may be the equivalent of the "big reveal" on a reality TV show, only what we're revealing on blogs and Twitter is the culture of healthcare. Making healthcare more transparent by sharing not what should be done, ought to be done, or even what we wish we could have done. SM seems to be a vehicle in full-throttle that captures what's actually done.

That said, I'm wondering how professionals who blog and tweet feel about their stories being picked up and used to illustrate how well the systems frontline clinicians rely on work (or, in many cases, don't work.) The knowledge, attitudes, values, and beliefs of individuals are reflected in the accounts we share. This information is often very personal, and it may reflect organizations individuals chose to identify. There's a lot of "hot talk" about respecting the privacy rights of patients in social media, but what about others?

My work focuses on how people perform within a system. The goal is to improve outcomes by improving the fitness of the system, being mindful of the strengths and limitations that humans bring to high-stakes endeavors. But this is not a universal approach, and "blame, shame, and re-train" approaches to performance improvement remain operational (even if they are not tacitly endorsed). For this reason, I chose not to "hot link" the stories I shared lest it draw unwelcome attention to individuals who simply shared a "day in the life of" account.

I'd love to have some feedback. Am I being overly cautious? Is posting and tweeting a "let the buyer beware" endeavor?


Becca Price said...

I agree with your "aggregator" approach to monitoring for and identifying patient safety gaps that have been either wittingly or unwittingly shared via social media. Protecting the source is consistent the principles of a just culture -- and not eveyone would look at episodes involving specific individuals or their healthcare systems with only the motivation to improve, not punish.

Kim said...

I wonder if having the filter "off" gives a more honest look at exactly how safe (or unsafe) the health care culture is.

It's interesting; I would have read those posts and taken them at face value (although I can understand why a dialysis machine would be labeled...), without consciously thinking about patient safety. In the context of your topic, it's crystal clear.

Not hot-linking was appropriate as you were describing a pattern you had found in health care postings. (Now if someone says, "hey, look what I did, don't make the same mistake" that is different.)

Sean said...

I'm with Kim. Being filter free is a way to truly 'educate' and 'protect'.
Just because we are sharing via the internet does not change the intended message, regardless of how good or bad the delivery may be, or how horrible the message can get.
I guess I'm being the devil's advocate here.
It's a gray area, in your case I think I may have done the same.

Barbara Olson, MS, RN, FISMP said...

Thanks all. I appreciate the feedback and am glad I trusted my gut. Nice to know that still works on occasion!

RehabNurse said...

I'm with Becca. I won't link to certain things because if they're not good, why bother?

I have to admit I occasionally carry saline flushes in my pocket, although, they are still wrapped in their protective plastic. Once it comes out of the plastic, it never sees the pocket again and gets used immediately. If it's open and I don't know where it's been, it gets tossed.

Just can't be too careful.

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