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It strikes me that when we design patient safety systems, we rarely think about the minds of those with them. And yet it seems intuitive the way systems are structured affects the way in which people use them. Could this be used proactively to make us safer doctors?
A good example from mundane daily practice - how to document cannulation. It's a widespread patient safety principle there should be a record of where and when a patient is cannulated so that the cannula could be checked for signs and symptoms of infection,[url=http://woolrichdeutschlandarcticparka.albirank.net/][b]Woolrich Parka G��nstig[/b][/url], and taken out following a timely period. In Hospital A, the machine was that a particular coloured A4 sheet of paper was filled in whenever a patient was cannulated, marking details of where, when, who and why. In Hospital B there was a specific 'cannula pack' which contained a disposable tourniquet, alcohol wipe, cannula dressing and a sticker with space for when and where details. The sticker ended up being placed on an identical A4 piece of paper
I'm a conscientious junior doctor,[url=http://duveticadoudoune.halod.com/][b]http://duveticadoudoune.halod.com/[/b][/url], I understand the chance of phlebitis and systemic infection from cannulas,[url=http://peutereyjacketsuppliers.webmium.com/][b]Peuterey outlet[/b][/url], and I am aware that with no written record nurses might not be conscious that the patient has a cannula in place,[url=http://wheretobuyrogerviviershoes.webmium.com/][b]where to buy roger vivier shoes[/b][/url], or when it must be removed. My very own motivation and data didn't change between your two placements.
However in hospital B after i had placed a cannula and that i had a sticker in my hand from the cannula pack,[url=http://parajumpersoutletjackets.webmium.com/][b]parajumpers bear vest outlet Hampton Roads Technology Council[/b][/url], I never threw it away. Even when I had been busy, even when it had been hard to locate the piece of paper,[url=http://rogerviviershoesshoponline.webmium.com/][b]roger vivier shoes shop online[/b][/url], it had been psychologically impossible for me to actively discard the sticker. It had been not only the truth that the sticker brought to mind the process (although which was extremely important),[url=http://rogerviviershoes.webmium.com/][b]http://rogerviviershoes.webmium.com/[/b][/url], it had turned safe practice into the default position,[url=http://duveticadoudoune.halod.com/][b]Femmes Manteaux Duvetica Soldes Femmes Doudoune Duvetica Pas Cher[/b][/url], instead of a choice. To toss the sticker away would be consciously giving my patient poor care.
In comparison, I probably had a 30% rate of success at filling out the coloured paper in hospital A - because I forgot, because I was busy, since the forms had run out,[url=http://woolrichdeutschlandarcticparka.albirank.net/][b]Woolrich Online Shop[/b][/url], because I had been doing other tasks and never got round to it.
If the small difference in the way that the system was structured could convert 30% performance to 90% performance, what potential is there to scale up and improve all aspects of patient safety systems simply in the way they are designed? You will find too many checkboxes and proformas in powerful weight loss products that can cover the factors that the creator thinks are essential,[url=http://peutereyjacketsuppliers.webmium.com/][b]Peuterey Jacket outlet[/b][/url], instead of being designed to function in the best possible method for their users.
Perhaps this is the next step in the arena of patient safety research - an integration of psychology and sociology to serve as tools for increased impact of patient safety initiatives?
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