The Running A Hospital blog has another discussion of dealing with medical error. This time, the hospital has opened up an error of its own (a wrong side surgery) for examination by the Open School of the Institute for Healthcare Improvement.
- From IHI’s Jim Conway: “Our systems are too complex to expect merely extraordinary people to perform perfectly 100% of the time. We as leaders must put in place systems that support great practice by people who suffer from being human and will make mistakes.”
- From a patient who had two surgical errors in ten months: “After years of suffering through our incredibly brutal tort(ure) system I finally had the chance to talk to the surgeon. The most meaningful words he spoke were the descriptions of how badly he suffered also from the event we shared in that OR. Finally I was not alone!”
As we’ve often said, participatory medicine brings a new kind of partnership between patient and caregiver. Neither denial nor a Wall of Silence (famous book) has any place in a healthy relationship. It breaks my heart to think of the good lives that are ruined by our cultural inability to deal with honest errors in complex situations.
Yes, as Linda Kenney of MITSS mentions in a comment, some employees (in any industry) are reckless and must be weeded out. That too can be a denial issue. But first, we need open discussion.