Normalization of deviance in diagnosis .... primary problems

BRIAN GOLDMAN drhbg at ROGERS.COM
Sun Jan 11 16:25:23 UTC 2015


The normalization of deviance is well discussed in John Banja's Medical Errors and Medical Narcissism.  http://www.amazon.ca/Medical-Errors-And-Narcissism/dp/0763783617
Normalization of Deviance is at the heart of many disasters from the Challenger explosion to the Exxon Valdez to Chernobyl to the train explosion and fire at Lac Megantic in Quebec. Brian Goldman, MD, MCFP(EM), FACEP
Mount Sinai Hospital, Room 206
600 University Avenue
Toronto, ON M5G 1X5
416-822-5044 phone
416-586-4719 fax 

     On Sunday, January 11, 2015 11:03 AM, Lorri Zipperer <Lorri at ZPM1.COM> wrote:
   

 <!--#yiv7063820639 _filtered #yiv7063820639 {font-family:Calibri;panose-1:2 15 5 2 2 2 4 3 2 4;}#yiv7063820639 #yiv7063820639 p.yiv7063820639MsoNormal, #yiv7063820639 li.yiv7063820639MsoNormal, #yiv7063820639 div.yiv7063820639MsoNormal {margin:0in;margin-bottom:.0001pt;font-size:11.0pt;font-family:"Calibri", "sans-serif";}#yiv7063820639 a:link, #yiv7063820639 span.yiv7063820639MsoHyperlink {color:blue;text-decoration:underline;}#yiv7063820639 a:visited, #yiv7063820639 span.yiv7063820639MsoHyperlinkFollowed {color:purple;text-decoration:underline;}#yiv7063820639 span.yiv7063820639EmailStyle17 {font-family:"Calibri", "sans-serif";color:windowtext;}#yiv7063820639 .yiv7063820639MsoChpDefault {font-family:"Calibri", "sans-serif";}#yiv7063820639 .yiv7063820639MsoPapDefault {} _filtered #yiv7063820639 {margin:1.0in 1.0in 1.0in 1.0in;}#yiv7063820639 div.yiv7063820639WordSection1 {}-->This short piece discusses the normalization of ineffective behaviors and their effect on medication safety. http://www.confidentvoices.com/2013/02/04/shortcuts-in-medication-administration-dangers-of-normalizing-deviance-keys-to-preventing-errors/  What poor behaviors are normalized that degrade the diagnostic process? What about not looking at evidence but relying on only one resource or only one colleague’s assessment to inform decision making?  Lorri  Lorri Zipperer, editorPatient Safety: Perspectives on Evidence, Information and Knowledge Transfer. London, UK. Gower. June 2014. ISBN: 978-1-4094-3857-1http://www.gowerpublishing.com/isbn/9781409438571free chapter http://tinyurl.com/n6e4st2LinkedIn Group / Patient Safety Partners: http://www.linkedin.com/groups?gid=163248  "everyone has to be his own leader, on his own sled."Joseph Beuys 


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