Tuesday, June 21, 2011
We have long believed that the eradication of wrong site and wrong patient surgery ranks amongst the lowest hanging adverse event fruit. Since the Joint Commission introduced its "timeout" and other procedures, available here, surely the problem is in decline. According to a perceptive Washington Post/KHN piece by Sandra Boodman, available here, that doesn't seem to be the case. The following extract quoting the Joint Commission president is illustrative:
“I’d argue that this really is rocket science,” said Mark Chassin... he thinks such errors are growing in part because of increased time pressures. Preventing wrong-site surgery also “turns out to be more complicated to eradicate than anybody thought,” he said, because it involves changing the culture of hospitals and getting doctors — who typically prize their autonomy, resist checklists and underestimate their propensity for error — to follow standardized procedures and work in teams.