Val Jones, M.D., CEO of Better Health, LLC, is the host of this week's edition of Grand Rounds, hosted on MedPage Today. Grand Rounds is the weekly compilation of the best posts from the Medical Blogosphere, and Dr. Val has done a great job putting together Ten Suggestions for Healthcare Reform.
« December 2008 | Main | February 2009 »
January 2009
Learning from Aviation - Lessons from Flight 1549
Many comparisons have been drawn in recent years between healthcare and aviation. Crew Resource Management training sessions are held in hospitals around the country with the intent of improving team communication and decision making. Critics argue that standardizations possible in aviation are not possible in healthcare. Proponents counter that many healthcare errors could be prevented through improved communication, which CRM training addresses.
This week's remarkable and inspiring story of US Airways Flight 1549 gives reason to again consider what healthcare can learn from aviation.
News reports abound with details about the dedication and training of the flight crew, in particular Pilot Chesley B. "Sully" Sullenberger. In addition to extensive flight experience, he has an avid interest in safety, having served as the Air Line Pilots Association (ALPA) safety chairman, and as an accident investigator. He is also the owner of Safety Reliability Methods, Inc., a consulting company focused on safety, performance and reliability. All of those factors helped prepare him to handle the extraordinary crisis of flight 1549.
It is however, important to remember that even the masterful work of Captain Sullenberger and his crew wasn't enough to avert disaster. The ferry boats, water taxis, Coast Guard, New York Fire Department, and others all played a part in bringing 155 passengers and crew to safety.
So what are the take-aways for physicians and other healthcare "pilots"?
- Know that experience counts, but it doesn't stand alone
- Nurture an ongoing passion for learning
- Remain open to innovative ways to improve safety
- Work willingly on quality improvement and patient safety initiatives
- Assist in "accident investigation" and share the results
- Understand that you don't do it alone; honor the work of others
Captain Sullenberger is being hailed as a hero, and few would dispute the accolade. Physicians and their extended teams quietly save lives every day, and few will find themselves publicly lauded for their efforts. But those of us who work in medicine know who our extraordinary leaders are. You are not just technically proficient in your chosen fields, but also steadfastly dedicated to providing safe and compassionate care. You are the doctors, nurses, administrators and others who respectfully and tirelessly work for ongoing improvement even when the tide moves against you.
You make a difference every day.
CMS Announces Three New "No Pay" Events
The Centers for Medicare & Medicaid Services (CMS) announced their final ruling for three new National Coverage Determination (NCD) Events.
Effective January 15, 2009 payment will no longer be made for Medicare patients in cases of:
(1) Surgery on the Wrong Body Part
(2) Surgery on the Wrong Patient
(3) Wrong Surgery Performed on a Patient
Full details are available on the CMS web site: http://www.cms.hhs.gov/CoverageGenInfo/EmailUpdates/ItemDetail.asp?ItemID=CMS1219457
Physician Sued for Rude, Possibly Abusive, Behavior
In a case that's making national news, a Chicago physician is being sued for bad behavior. In general those kinds of charges are leveled against a physician by a hospital or by a professional colleague; in this case the charges are being made directly by a patient.
Catherine Skol, a former Chicago police officer, is suing Scott Pierce, M.D., an ob/gyn who filled in for her regular obstetrician at the birth of her fifth child in March, 2008. Ms. Skol alleges in part that Pierce refused her requests for anesthesia, demanded that she push at inappropriate times, and used a 25 gauge needle to suture a small tear in the vulva.
The Presidio Insurance Blog offers additional commentary and then poses this question, "In the final analysis, the mother and child are both healthy, though. Can a healthcare provider be held accountable for being rude?"
Of course, if the allegations are accurate, most would agree that there was more than rudeness involved in Ms. Skol's care, and that this is a physician who at minimum needs serious counseling before being permitted to practice again.
Read the Article from the Chicago Tribune: Woman Accuses Doctor of Making Painful Labor Worse
January is National Mentoring Month
January is National Mentoring Month, and the Harvard website shares stories from many well known people about how mentors enriched their lives. Dr. Deb writes with fondness on her blog about being mentored and in turn mentoring children and young adults along the way.
Mentoring however, isn't just for the young. I am always looking for mentors. My nephew, a computer networking guy, mentors me from time to time on all things electronic. He recently showed me a couple of clever tips for my Blackberry. It's quite a good thing to have a geekey mentor; their knowledge can be invaluable.
My business site, Simple Data Solutions, features a database that I could not have developed without the aid of a mentor.
Since I enjoy writing I'm often called upon by friends and co-workers to review articles, reports, homework, even book drafts. It's one of my favorite mentoring roles because i just LOVE my red editor's pen. When possible I ask the author to sit with me while I edit so we can talk about any changes. The end product we create together is always better than what I could have done alone. I receive the exchange benefit of gaining in-depth knowledge of the topic from the author.
Not everyone is willing to take on the role of mentor. It requires time, patience, a desire to share knowledge, and willingness to accept that a mentee may excel, perhaps beyond the mentor's own skill.
Mentors make the world a better place. If you haven't yet taken on the role, this month would be an excellent time to give it a try.