On the way to the hospital this morning, I heard a report from NPR’s Dan Charnas about mise-en-place, the chef’s philosophy and discipline for organizing and managing a hectic commercial kitchen. The piece was a great reminder that many of the challenges we face in healthcare are shared by others. Chefs standardize their procedures, prepare meticulously for each workday, and read back instructions from their colleagues to keep orders straight in the hectic kitchen. They also “work clean” and practice “clean as you go” to keep their workspaces organized and their food safe. When something’s not right, the chef “slows down to speed up” by taking time to correct any problems before a dish reaches a customer. A few weeks after Telluride it was a great reminder that we can get inspiration and motivation for patient safety practices anywhere!
At Telluride East today we were all touched by the story of Lewis Blackman. The care he received suffered during night and weekend hours when coverage was limited to housestaff. We discussed how making the decision to call an attending about a patient can be a difficult one, especially if the hour is late. I was delighted to learn today that at some hospitals, attendings and residents have come together to agree upon a list of ten patient situations that will always always generate a phone call from the resident to the attending, regardless of day or time. Further, at the end of the call, the attendings have agreed to thank the resident for reporting the situation.
This practice parallels a concept from military doctrine. In order to succeed in his or her mission, every commander requires up-to-the-minute information about the status… Continue reading