November 10, 2006
I saw a documentary last night about safety in hospitals. It was about a new movement to put a stop to preventable deaths due to hospital errors.
The movement was initiated by a woman whose baby girl died as the result of neglectful treatment at Johns Hopkins University. Instead of clamming up and defending itself against her lawsuit, the hospital opened its files and worked with her to figure out how to prevent such tragedies in the future.
This woman's efforts - along with others - has become a nationwide initiative to reform hospital culture and, thus, increase safety. The biggest culprit, the documentary suggested, was the traditional, vertical power structure that exists in hospitals. Orders come from the top down. The nurses, who are the caretakers, are trained to blindly follow doctors' orders, even when they don't make sense.
This film tied into something I read in Robert Cialdini's Influence: The Psychology of Persuasion in his chapter on the power of authority.
Cialdini cited two studies indicating that the rate of mistaken medication dispersal at hospitals was 10 percent and 12 percent over a 10-year period. The reason, researchers discovered, was the nurses' over-reliance on the doctors' authority.
In many cases, for example, the nurses believed a doctor's recommended treatment was wrong, but said nothing because "he's the boss."
A particularly memorable example: One nurse administered eardrops to a patient's anus, because the doctor's note said "R ear" (meaning right ear).
The new program developed at Johns Hopkins (and replicated in a growing number of other hospitals around the country) includes:
* A swat team of doctors and nurses who converge to examine a patient as soon as something seems "wrong"
* The right of a patient's friends or family members - or, in some cases, the patient himself - to call for those swat-team visits (as opposed to the traditional protocol, which involves going through the attending physician)
* An open policy toward disclosing information about mistakes with patients and families of patients
Watching the documentary had me remembering some of my own hospital experiences:
* Before surgery, asking common-sense questions, only to have the doctor brush them off as "nothing you need to worry about"
* Being unable to get good answers from doctors at hospitals when my mother was ill
* Getting the same treatment (and having the same humiliating feeling of powerlessness) when my father was dying
All this has me thinking. I wonder which of the hospitals where I live have initiated the Johns Hopkins program? I think I'll find out.
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posted by M. Masterson @ 10:05 AM,
- At 7:24 AM, said...
I read your comments about hospital errors and John Hopkins. hospitals are policing themselves. I work in a ICU. You might want to check out the 100,00 lives campaign,
- At 12:20 PM, said...
I hope these efforts are fruitful.Often, such professed intentions to "clean up one's act" turn out to be nothing more than smokescreens.
Our daughter suffered a huge abscess on her abdomen. Why? Because the underlying tissue was stitched together by sutures that were supposed to dissolve but instead were black, indissoluble "thread" - 2 huge pieces, one with a knot onthe end of it, and had to be removed in a separate surgical intervention.
More pain, risk, misery, expense, more antibiotics and pain-killer medicines.
Hospitals are dangerous places to be, especially whenyou're sick !!
Now, isn't that a sorry state of affairs!