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because people call it cookbook medicine," Mr. Byrum acknowledges.
"The greatest barrier to adopting high-reliability organization (HRO)
principles and practices is a cultural hierarchy where autonomy is a
core value. Physicians complain that tools like checklists detract from
their autonomy and lack a personal touch. But these objections aren't
only dangerous, they're absurd. If you have the opportunity to choose
between an OR that can statistically ensure greater safety by using
HRO principles and one that can't, which would you choose? It's a
moral obligation to significantly decrease the chance for human
error."
For some providers, however, the choice may not be quite that
clear-cut.
"They're not saying I don't care about this," says Dr. Ring. "They're
just doing it in a less stringent way because they've gotten used to
doing it that way. I do see things changing, although probably slower
than most people want. More and more, people are saying things are
going to happen. That doesn't mean you're a bad surgeon or a bad
person and it doesn't mean you're reckless or careless — so let's build
the systems and coach people and give them feedback to make sure
surgeons are as safe as possible."
"There isn't a person in the world that isn't capable of making an
error, given a sufficient number of distractions or communication
breakdowns," says Mr. Byrum. "You're not always at your absolute
best, so why wouldn't you have a system in place that would catch
and correct the error before you put yourself and your patient at risk."
"The right mindset is humility," sums up Dr. Ring. "You just know
you're going to make mistakes. As smart as you are, as focused as you
are, as trained as you are, there are things that will distract you, there
are ways to lose focus."
P R E - O P S A F E T Y
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