[No SPF Record] [IMPROVEDX] Culture

Bob Latino blatino at RELIABILITY.COM
Tue Jun 12 14:02:30 UTC 2018


Along this thread I thought this article may be of interest.  Declarations of 'zero' metrics, often has unintended consequences.  While on the surface they seem logical and admirable, they can suppress feedback loops for fear of affecting the zero metric (such as zero harm).

The article is authored by noted safety researcher Sidney Dekker.

Does this 'zero' mentality fall into the realm of how success in reducing Dx error is measured?  Is it applicable?

Regards
Bob Latino

Robert J. Latino, CEO
Reliability Center, Inc.
1.800.457.0645
blatino at reliability.com
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From: Rory Jaffe [mailto:rjaffe at CHPSO.ORG]
Sent: Monday, June 11, 2018 3:04 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] [No SPF Record] [IMPROVEDX] Culture

The other studies show a reasonably strong link.

Some of the problems in making an overall assessment is that culture is very local, varying broadly from department to department within an organization. Within-organization variability is generally much higher than between-organization vulnerability on safety culture surveys. So studies that look at "culture" in the organization as a whole tend to have weaker results. The specific papers do show a decent link.

Also backing this conclusion is that, in other industries, this has been studied and there is a definite link between culture and safety.

I think there is a consensus in health care that there's a link. Look at "to err is human" and subsequent publications from the National Academy of Medicine. These publications strongly presume that culture is important driver of safety.


From: ROBERT M BELL <rmsbell200 at yahoo.com<mailto:rmsbell200 at yahoo.com>>
Sent: Monday, June 11, 2018 10:47 AM
To: Society to Improve Diagnosis in Medicine <IMPROVEDX at list.improvediagnosis.org<mailto:IMPROVEDX at list.improvediagnosis.org>>; Rory Jaffe <rjaffe at chpso.org<mailto:rjaffe at chpso.org>>
Subject: Re: [No SPF Record] [IMPROVEDX] Culture

Thanks Rory Jaffe,

Very kind.

Do you yourself have an overall opinion? I looked at the Weaver article which evaluated many studies. and, from my limited interpretation, that did not seem too positive.

Is there a general consensus amongst the medical profession as to whether culture is important in preventing errors?

Is to ERR more resistant to intervention than we think?

Rob Bell


On Jun 11, 2018, at 9:58 AM, Rory Jaffe <rjaffe at chpso.org<mailto:rjaffe at chpso.org>> wrote:

Weaver SJ, Lubomksi LH, Wilson RF, Pfoh ER, Martinez KA, Dy SM. Promoting a culture of safety as a patient safety strategy: a systematic review. Ann Intern Med. 2013;158(5 Pt 2):369-374. doi:10.7326/0003-4819-158-5-201303051-00002.


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