Researchers want a better system for fixing bad science | The Verge

Peggy Zuckerman peggyzuckerman at GMAIL.COM
Fri Feb 12 18:19:12 UTC 2016


And, "What you permit, you promote."

Peggy Zuckerman
www.peggyRCC.com

On Fri, Feb 12, 2016 at 8:12 AM, Carl <carl.keldie at gmail.com> wrote:

> Simplified:
> "You have to inspect what you expect"
>
> Sent from my iPhone
>
> On Feb 11, 2016, at 5:43 AM, Bob Latino <blatino at RELIABILITY.COM> wrote:
>
> Hi Peter
>
>
>
> I thought you might like this concept.
>
>
>
> *Care Journals* by The Josie King Foundation
>
>
>
> http://www.josieking.org/carejournals
>
>
>
> I have always liked this idea of providing patients Care Journals to keep
> records during loved one's stay in a hospital.  I think all involved 'win'
> when everyone actively participates in the quality delivery of care.
>
>
>
> Just an FYI.
>
>
>
>
>
> *Robert J. Latino, CEO*
>
> Reliability Center, Inc.
>
> 1.800.457.0645
>
> blatino at reliability.com
>
> www.reliability.com
>
>
>
> *From:* Elias Peter [mailto:pheski69 at GMAIL.COM <pheski69 at GMAIL.COM>]
> *Sent:* Wednesday, February 10, 2016 4:45 PM
> *To:* IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
> *Subject:* Re: [IMPROVEDX] Researchers want a better system for fixing
> bad science | The Verge
>
>
>
> " I kept daily lists of the errors and worked with the Risk Managers to
> resolve.”
>
>
>
> If I had a magic wand, I would require that all hospitals create a group
> of 'safety observers’ that would include patients, provide some training in
> systems and medical care, and then pay them to sit and observe and take
> notes and report regularly (monthly at least) to administration/risk
> management and involved departments to identify, prioritize, and address
> safety issues.
>
>
>
> I think there is a simple logic to this: direct observation of process by
> independent individuals with different perspectives will see and find
> things that no fancy internal risk management system will see.
>
>
>
> Peter Elias, MD
>
>
>
> On 2016.02.09, at 7:50 AM, Bob Latino <blatino at RELIABILITY.COM> wrote:
>
>
>
> The U.S. spends ~17% of its GDP on Healthcare or about $3 Trillion/yr (or
> ($9,323/person).  It is hard to believe we do not throw enough money at
> it.  It is how we use the monies so inefficiently and ineffectively that is
> the problem.  For all of the money thrown at HC, our mortality rates as
> compared to the rest of the world do not demonstrate ours was money well
> spent.  Why not?
>
>
>
> To put this into perspective France and Switzerland spend 11% of their GDP
> on healthcare.  The Middle East spends much less (see below).
>
>
>
> <image003.png>
>
>
>
> *Source: *
> https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/highlights.pdf
>
> *Source: *
> https://www.cia.gov/library/publications/the-world-factbook/rankorder/2066rank.html
>
> *Definition:* The *crude death rate* is the number of *deaths* occurring
> among the population of a given geographical area during a given year, per
> 1,000 mid-year total population of the given geographical area during the
> same year.
>
>
>
> Because the manner in which death rates are collected, deaths due to
> 'medical' error are not uniformly collected or collected at all in many
> countries.  So the only uniform measure of death is called the 'crude death
> rate' around the world (see definition above).  Deaths due solely to
> medical error are included however, the split (%) is not discernible.
> Regardless, when you look at the investment in HC as opposed to GDP, and
> overall crude death rate/1000 total population, the numbers are varied and
> quite startling.  Why do these countries with the lowest investment in HC
> as a % of their GDP, also have the lowest crude death rates in the world?
>
>
>
> I know there are many researchers on this forum who will chew this up and
> explain to us the reasons; but as a layman, I am interested in learning why.
>
>
>
> Irrespective of what the studies in the link Rob provided conclude, just
> sitting in any hospital for a day and observing, one can make a list of
> errors for themselves.  To me, it is hard to imagine a hospital stay
> without an error occurring the course of the delivery of care.  Both of my
> parents passed in the last 9 years and both were in ICU's for 2 - 4 weeks.
> We stayed with them 24/7 during those stays.  I kept daily lists of the
> errors and worked with the Risk Managers to resolve.  I know what I am
> looking for, just think of those who do not and just 'trust' their care
> givers and their delivery of care systems. Are they told of these errors?
>
>
>
> I believe Rob's point is not that the errors are not occurring, but what
> is the scope and magnitude of them?  How do we accurately identify,
> quantify and prioritize them so we can focus on solving them in a logical
> manner?  How do we do this in a fashion where actions replace words and
> change can be observable in the near term (instead of during our
> lifetime)?  Certainly there are more complex issues that will take longer
> to resolve but I believe the 80/20 applies here as well.  I suspect that
> 20% or less of the error types (Failure Modes we call them in my business)
> account for 80% or more of the total occurrences.  Certainly we can act on
> this 'low hanging fruit' in the 20% range (or what we call the Significant
> Few).
>
>
>
> Bob Latino
>
>
>
>
>
> Robert J. Latino, CEO
>
> Reliability Center, Inc.
>
> 1.800.457.0645
>
> blatino at reliability.com
>
> www.reliability.com
>
>
>
>
>
> -----Original Message-----
> From: Robert Bell [
> mailto:0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG
> <0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG>]
> Sent: Monday, February 08, 2016 10:09 PM
> To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
> Subject: [IMPROVEDX] Researchers want a better system for fixing bad
> science | The Verge
>
>
>
>
> http://www.theverge.com/2016/2/3/10897938/science-correction-process-problems-report-university-alabama
>
>
>
> This supoports the concept that the diagnostic infrastructure is overall
> in a bad state. Is money the big problem - too much or too little?
>
>
>
> Rob Bell
>
> Sent from my iPad
>
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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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