Doctors to act like Pilots?

AdamZ

AdamZ

Touchdown! Greaser!
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Adam Zucker
Just saw a piece on the news that was captioned Doctor's are begining to act like pilots. Segment was basically about how Hospitals are having thier surgeons use check lists pre surgery to reduce errors and how they are using CRM type methods in the OR.

I guess Bruce is way ahead of the game:D
 
Does this mean that Bonanzas are going to be safer now :smilewinkgrin:
 
Its true, but not widespread that I'd heard. We really could use it, not just Drs but all medical care folks (all species too!)
One eg: - medication errors - seems like I read a reliable source say we injure and kill hundreds of thousands each year.
We could all benefit from applying checklists and taking out some of the human error part in medicine (and, medicines).
 
Checklists have been proven to be very effective reducing the incidence of medical errors and preventing complications of routine procedures. But in medicine, just like in aviation, there are physicians and other health professionals who refuse to use checklists. They are perceived by some as a sign of weakness, just like some pilots. "I don't need no checklist, watch this...!

The most simple 3-item checklist before every procedure has prevented thousands of errors:

1. Is this the right patient? Check two ID (Mr. or Mrs. X, Please say your name and date of birth and please let me see your wrist band).

2. Is this the right procedure? (You don't want to start a colonoscopy on someone who is there for a skin biopsy :D)

3. Is this the right side of the body? (You don't want to remove the good kidney :frown2:)

Believe it or not, these things happen in hospitals, unfortunately. I'm the king of checklist advocacy. But some of my colleagues go: "Gil we're not flying this patient, we're just giving him an enema." :blush:

Seriously, we have a long way to go but we've started down that path. Each of you can help the process along. The next time your doctor is about to start examining you, ask him or her politely, to please wash his or her hands right in front of you. Don't take the "I did it before I came into the room" excuse for an answer. The most simple procedure in medicine, wahing hands with soap and water, can prevent thousands of deaths and illnesses.
 
We have for several years now had a two-person mandatory double check of all medications, one fills the rx, another checks the label, the pills, reviews the record before it goes out the door. Has caught a few things, too.
 
Couple years ago I was in for a thrombosis in my leg. I'd read an article on hospital mistakes before the ACL surgery, and before I went into the cutting room I took a black magic marker and made a big X on my other knee, with the word "NO" above it. The cutter thought it was pretty funny.

Then, during a fun stay in the hospital I made a point of watching the medications while I was in and found 4 minor errors, just on me. I wonder what they thought of my list when I checked out, prolly went in the trash bin.
 
bbchien said:
'been doing this for five years.....
Click to expand...

Don't take this the wrong way, but how does using a checklist impact your patients' confidence?

Basically, in the same way that some non-pilot pax comment about us pilots using a checklist in our small planes instead of just "knowing".
 
I have an allergy so to speak that can only create an issue if I get a transfusion. Before undergoing surgery to donate bone marrow I had my wife write the issue in black sharpie on my back. The MD thought it was great and said everyone in the OR got a good laugh as well.
 
There was a news item just a few months back that in spite of the quadruple checks the surgeons made a huge mistake.

The news should add the "chain of errors" followup.
 
Pi1otguy said:
Don't take this the wrong way, but how does using a checklist impact your patients' confidence?
Click to expand...

Most of the time when checklist are used, the patients are either under anesthesia or too sick to notice (PICU/NICU/PACU/SICU settings). If they are awake or when they find out later, they feel reassured for the most part. There are always exceptions.

I don't do procedures, except pelvic gyn examinations and ocassionally spinal taps or lumbar punctures which I prefer to let my neuro colleagues take care of. But when I do, I make sure I have everything I'm going to need ready before me and I go through my personal checklist.

To prevent medications errors I do a lot of drug checking. Since my patients are mostly teenagers and they take a lot of different drugs and I mean legal prescription drugs, I always have my iphone with me where I have an application that includes an extensive album of pictures of many drugs. I show them to my patients to confirm what they are talking about or to make sure they know what they should be getting from the pharmacist. Their parents loved it and the kids think I'm the coolest doctor in the world!
 
Doctors have always acted like pilots. We've all always had inflated opinions of ourselves.
 
How do you know if there is a doctor in the room?...He'll tell you!

(cricket...cricket...)
 
Here's something else I do with EVERY consult with a MD. I make them put on my chart that if there is a medication it must be reviewed by my AME with his phone #. It saved me a mistake once already.
 
docmirror said:
Here's something else I do with EVERY consult with a MD. I make them put on my chart that if there is a medication it must be reviewed by my AME with his phone #. It saved me a mistake once already.
Click to expand...

Yeah. Do that but I don't count on my M.D. to make the call. I pretty much know by now what kinds of things are bad.

You can also ask the AOPA Medical desk.
 
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