Failing to check all the boxes ...

Michael.H.Kanter at KP.ORG Michael.H.Kanter at KP.ORG
Thu May 2 03:16:51 UTC 2013


i agree with you on the flying being prefered over going to an ED,but not 
for the reason you state.   I would take a well trained pilot without a 
checklist over a doctor who has a checklist but no concept of teamwork, 
collaboration, safety culture, and human factors knowledge but is using 
the checklist in a mechanical non thinking fashion.  Yes, we see the 
pilots using the checklist but that is simply what we see.  What we dont 
see is their attitudes about the checklist.  As an example, for years 
blood transfusion required two RNs using a checklist and reading off 
identifying information and blood types and unit numbers yet the wrong 
blood was still hung not infrequently.  The checklist may be necessary but 
it is far from sufficient.

Michael Kanter, M.D.
Regional Medical Director of Quality & Clinical Analysis
(626) 405-5722 (tie line 8+335)
THRIVE By Getting Regular Exercise

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From:   Lorri Zipperer <Lorri at ZPM1.COM>
To:     IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Date:   05/01/2013 04:43 PM
Subject:        Failing to check all the boxes ...



From: Nonie Leonidas [mailto:nonieleonidas68 at gmail.com] 
Sent: Wednesday, May 01, 2013 5:36 PM
To: Society to Improve Diagnosis in Medicine; Michael.H.Kanter at kp.org
Subject: Re: Lack of time, knowledge or just sloppy thinking? ... Failing 
to check all the boxes ...
 
Hi Micheal,
 
The next time you fly please take the first row, in smaller plane, and 
watch what the captain and co-pilots are doing.
 
They are minding their checklist, checking them off, and the co-pilot 
checking it again.
 
When both of them are sure that all of the boxes had been checked-off, 
that is the only time they will lift-off.
 
And that is the reason why I would fly any day rather than visit a doctor 
or an ER.
 
Nonie Leonidas
Philippines

On Thursday, May 2, 2013, wrote:
In my view it is not the checklists per se but also the culture that 
accompanies the checklist that creates safety and reliability.  Checklists 
alone do not add all that much value



Sent with Good (www.good.com)



-------- Original Message --------

From :      Alan Morris <Alan.Morris at IMAIL.ORG>
To : IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Cc : 
Sent on : 05/01 07:07:38 AM PDT
Subject : Re: Lack of time, knowledge or just sloppy thinking?

If we did this to pilots, no one would fly.
Paradoxically, we have tools to address this – but virtually no support of 
interest from funding agencies to pursue development.
Have  a nice day.

Alan H. Morris, M.D.


From:  "Dr.Will" <dr.will at fuse.net>
Date:  Wednesday, May 1, 2013 7:54 AM
To:  'Society to Improve Diagnosis in Medicine' <
IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>, "Alan H. Morris, MD" <
alan.morris at imail.org>
Subject:  RE: Lack of time, knowledge or just sloppy thinking?

Yes and EMR data entry requirements have exceeded human capability to 
provide good clinical care (and both eyes and physical contact on patient) 
in the compressed time allotment by insurance payment and hospital owned 
productivity requirements. No wonder there are errors in DX and Outcomes.

If we did this to pilots, there would be more errors, as well. My brother 
is a retired pilot.

Will Sawyer, MD

 
 


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