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Escape Fire

A popular documentary movie is making the rounds now called, “Escape Fire, The Fight to Rescue American Healthcare” that is challenging us to take a closer look at our healthcare delivery system.  The movie came out originally last year and won a number of awards for its documentary content and CNN is showing it again with added discussions between a few well-known healthcare advocates.  I’m excited that there is a renewed focus in America on creating system wide solutions and efficiencies that will have a positive impact on patient safety.  Two topics run through the movie, one deals with the need for a more holistic and preventative approach to health and healthcare in America and the other with the system of healthcare delivery itself.  Both of these topics dovetail perfectly with the high reliability mindset that I advocate on this site. This spike in interest on healthcare system safety is perfectly timed to go along with the blog post from last week where I spoke about habits and culture of healthcare delivery and exploring ways to use our high reliability mindset skills to enhance our safety culture.  The movie offers added insight into this important principle.

The movie also emphasizes some parallels between aviation safety methods and patient safety skills that I have stressed on this site from the beginning and have used myself on many occasions.  Check back on the early topics of aviation safety and patient safety.   They quote a statistic that 30,000 patients die every year from errors in treatments that they didn’t need in the first place.  I’m not sure what the exact numbers are but there is just no longer any argument that a number of patients are injured (sometimes fatally) in our attempts to make them better. Certainly, none of this is intentional but, as the movie says, there are industries that have figured out how error happens and methods to prevent it.  This point is the central topic of this entire blog and I totally agree that we need to change our habits and cultures to adopt these error avoidance principles.  By understanding and predicting when bad things might happen we can set ourselves up for success and avoid mistakes just as the blog post on imagination details.

We can’t legislate against human error but we can insist in our practice that we use of known tools to enhance communication, trap small missteps before irreversible mistakes happen and understand and respect the limits of our own physiology that leads to error.  We can also train our medical students, residents and yes even ourselves in understanding our own knowledge and skill limitations so we stay within our own “personal minimums”.  I discussed this in the post on this topic.  If nothing else this defines our profession of medicine and our professionalism as physicians.

The movie makes the case that the costs of errors in healthcare delivery are contributing to the crippling financial burden that healthcare is imposing on our society.  There are several ways to address costs but certainly using our high reliability mindset skills to avoid these errors in the first place can have enormous benefits to our patients, their families and our entire society.

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Posted in High Reliability Mindset, Human Factors, Patient Safety.


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