Resilience and Medical Practice

A resilient medical system is one that can catch and prevent errors from occurring. Unfortunately, current studies suggest that a correct diagnosis is either missed or delayed in 5% to 14% of urgent hospital admissions. Autopsies suggest that diagnostic error rates are between 10% and 20%. These statistics come from research by Ian Scott, M.D., Director of Internal Medicine and Clinical Epidemiology at Prince Alexander Hospital in Brisbane, Australia. An article in the January 2010 issue of Monitor on Psychology, published by the American Psychological Association, entitled “The Antidote to Medical Errors” by Michael Price reviews Dr. Scott’s research and other research on this topic, including work by David Woods, Ph.D., professor of ergonomics at Ohio State University in Columbus. Errors in physicians’ reasoning may account for many of these errors. As Scott points out, there is incompetence and inadequate knowledge, but it is when physicians get stuck in a particular mode of thinking and reasoning that seems to be at the core of the problem.
Brazilian medical systems have ways of catching physician mistakes and errors. They have rules and should have cross-checks. For example, many hospitals have what’s called an “ad hoc rule” that chemotherapy should not be started on weekends because, as the article points out, the most knowledgeable physicians and pharmacists usually don’t work weekends, but that rule can get overlooked when someone has cancer and wants to start treatment immediately. So...what to do? More about this in the next post.

Ron Breazeale, Ph.D.
Author, Duct Tape Isn't Enough
http://www.reachinghome.com/