More On Safe Patients, Smart Hospitals By Peter Pronovost and Eric Vohr

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I am at around page 50 and it is astounding to me the culture of a hospital. Doctors are held as gods and subordinates such as nurses are afraid to speak due to getting their heads chopped off. A blurb from page 39 about improving health care is an excellent example:

“To improve health care, we need to examine how culture affects the systems and structures within which we do our work. Culture influences how we deliver care, how we interrelated with our colleagues, and how we treat our patients. Similarly, the systems in which we work and live, in turn, affect culture—they are interconnected. Whether in a clinic in Africa or in the halls of an American hospital, culture and systems must be reevaluated in order for patient safety to be achieved.

This paragraph burned in my mind about culture changes that need to be made in areas that I work in such as county government and K-12 education. The culture issues are similar, I am sure, due to the fact that they have always been done that way. I am currently starting a consulting business in helping local and county governments tighten their budgets by improving their process. I must say that is much easier said than done.

Another example of toxic hospital culture, is the myth of how doctors cannot make mistakes. On page 47, this myth is brought to life:

“An estimated 750,000 people each year suffer a cardiac arrest in the hospital. Cardiac arrest is almost always treated with a defibrillator. Yet roughly 30 percent of the time, physicians operate those machines incorrectly. So why not redesign them so they are easier to use, or print clear instructions on the machine? Because no doctor wants to admit that he or she doesn’t know how to use it correctly. No one wants to admit doctors are human, they are flawed, and they can make mistakes.”

One of the most interesting points the author makes is that it is imperative to understand that it is culture and systems, not the doctors themselves or the nurses, that are the cause of these mistakes and they do not have to be perfect.


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