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A Bad Err Day

By Jock Hoffman, CRICO

Related to: Emergency Medicine, Primary Care, Obstetrics, Other Specialties, Surgery

We can assume that health care providers make fewer mistakes on those days when they are not overly busy, easily distracted, constantly being interrupted, stressed, or dealing with personal issues, a leaky water heater, or their car’s check engine light. You know those days, right?

Of course, health care providers generally do function safely and effectively under challenging conditions. From the relative “quiet” of a private practice to the more frenetic pace of EDs, L&D units, ORs, understaffed labs, and overbooked imaging suites, health care delivery is carried out in an environment that would likely immobilize many non-health care professionals. Physicians and nurses, however, learn how to filter out numerous everyday distractions and navigate around routine diversions without compromising their vigilance to the patient’s care and safety.

Almost all of the time.

But even those of you who thrive amidst organized chaos can become preoccupied with a nagging concern, take on one task too many, or let down your guard. Of course, this is when you are most vulnerable to making errors, or to not catching your mistakes quickly enough to rescue the situation. This is when you need an extra ounce of vigilance to prevent patient harm and, perhaps, an allegation of malpractice.

So what throws you off your game?

  • A new piece of equipment, new software, a new form to be filled out?
  • A schedule snafu, a change in team members, a workplace dispute?
  • A patient who reminds you of a loved one…or resembles a crabby neighbor?
  • The day before or after vacation, or the first or last day of being on service?
  • A pending malpractice case or a near miss?
  • Traffic, a fight with your spouse, too many meetings?
  • Something in the mirror that doesn’t look right, or a new and undiagnosed pain or ailment?

Many adverse events stem from seemingly small missteps in the patient’s care. Self awareness of what might set you up for a substandard performance is an important step in developing strategies to compensate and perhaps avoid those little mistakes that can have big consequences.

 

ADDITIONAL READING


March 28, 2013
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