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Beyond the Checklist: What Else Health Care Can Learn from Aviation Teamwork and Safety (Culture and Politics of Health Care Work) [Englisch] [Taschenbuch]

Suzanne Gordon , Patrick Mendenhall , Bonnie Blair O'Connor

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Die hilfreichsten Kundenrezensionen auf (beta) 4.9 von 5 Sternen  11 Rezensionen
6 von 6 Kunden fanden die folgende Rezension hilfreich
4.0 von 5 Sternen Thoughtful advocacy of applying lessons from aviation safety to health care 26. Dezember 2012
Von E. Jaksetic - Veröffentlicht auf
The aviation industry, in conjunction with aviation regulators, developed a comprehensive system of safety practices and procedures to deal with a broad range of recurring problems that were causing aviation disasters and serious accidents. This book discusses the history of those safety efforts, identifies the critical elements of aviation safety, and argues that health care professionals can learn important lessons that could be applied to significantly reduce medical errors and improve patient safety.

The authors provide an informative look at the history of the development and application of Crew Resource Management (CRM) and threat and error management (TEM) by the aviation industry. They provide a realistic picture of the strengths, weaknesses, and limitations of CRM and TEM, and do not lapse into a simplistic or superficial advocacy of CRM and TEM as panaceas or "quick fixes" for health care professionals trying to reduce medical errors and improve patient safety. Also, the authors are careful to note both similarities and differences between the aviation industry and health care in their discussion, and avoid relying on facile or superficial analogies or comparisons that would undermine their contentions, arguments, and recommendations.

Overall, this book provides an excellent, thoughtful discussion of how the hard-earned lessons of aviation safety can provide insights and ideas that could help reduce medical errors and improve patient safety. Unfortunately, the three case studies about health care institutions used to support the authors' contentions, arguments, and recommendations have an uneven persuasive quality. The first case study provides support for the authors' contentions about the applicability of CRM and TEM to health care. The second case study is the weakest of the three because it does not provide any clearly discernable support for the authors' contentions about the applicability of CRM and TEM to health care. The third case study also provides support for the authors' contentions about the applicability of CRM and TEM to health care, but it is not as persuasive as the first case study.

Despite the criticism made about the uneven quality of the three case studies, I highly recommend this book to anyone interested in the subject of reducing medical errors and improving patient safety. The interdisciplinary approach taken by the authors is very helpful in providing useful insights and a different perspective that could help reduce the risk of occupational and professional myopia and "blinders" similar to those that the aviation industry had to confront and overcome before CRM and TEM could be effectively adopted and applied.
3 von 3 Kunden fanden die folgende Rezension hilfreich
5.0 von 5 Sternen MUST-READ For Medical Simulation Champions 10. September 2013
Von Lance Baily - Veröffentlicht auf
I can tell you now is a definite MUST-READ for anyone engaging within any avenue of healthcare, education, and/or simulation. This book goes beyond highlighting key examples of the poor communication practices causing systemic failures within healthcare by also providing a direct roadmap to solve these archaic human-made challenges. The authors poignantly remind us that the status quo of healthcare communication can no longer remain "just the way it is".
In Beyond the Checklist, Suzanne Gordon:

1) Diligently lays out the crisis of communication failures occurring within healthcare.
2) Reminds us of the history of similar communication failures within commercial aviation.
3) Demonstrates the 30+ year process of research, program development, and training systems implemented within aviation with regards to communication and team-management.
4) Powerfully explicates "Crew Resource Management" (CRM) as an evolved system for team interactions and operational success.
5) Highlights successful uses of the initial healthcare version of CRM called TEAMSTEPPS.
6) Directs our attention to the unavoidable future of healthcare including regulatory bodies and advanced data-capturing systems.

Most incredibly, Suzanne and her co-authors break down the individual components that make up successful team communication, demonstrates how those pieces are failing within healthcare structures, and provides direct examples of how those issues have already been successfully addressed within aviation.

Read full review at: [...]
3 von 3 Kunden fanden die folgende Rezension hilfreich
5.0 von 5 Sternen LOVE THE INFORMATION 10. März 2013
Von The Way I See It - Veröffentlicht auf
Format:Taschenbuch|Verifizierter Kauf
I have survived in flying a private plane for many decades... Found out (from this book) a lot about how I can improve my odds of lasting many more decades. I knew commercial pilots years ago who hated the changes that were happening in the airlines with CRM who were like me (old style seat-of-the-pants pilots) and only trusted themselves.They did not want to listen to input from others when decisions were to be made in the plane. They were THE CAPTAIN!

Those of us who survived being "Lone Rangers" of those years got ourselves in and out of trouble several times because we knew we had to do things on our own (macho). If we knew then what we know now, several pilots from years past would still be here instead of augered into terra firma.

This approach is needed in health care because I know nurses who've witnessed many critical errors in surgery, and in prescribing, that could have been avoided if they were allowed to suggest anything to the white coated autocrat. But, sadly, the heirarchy did not allow them to speak up for fear of losing their jobs.

Egos have taken many lives, and it is time for that to end. Gary Null researched the safety of medical care, and wrote "Death By Medicine". He reported that medical care kills almost a million people per year and is the leading cause of death in this country. Many physicians need to become accountable instead of relying on pharmaceutical reps, hospital management, etc. to tell them what to do (and protect them if they make a mistake). An attorney I know will not even do medical malpractice cases because he said "Good luck in getting an MD to testify against another MD." It is not a "transparent" group or organization.

The "standard of care" in medicine is not what should be done in so many cases! You and I have heard the stories of death and debilitation because of errors we knew were done... It is time for many doctors to refer out for other opinions with different providers, and get feedback from professionals outside their tight knit little cliques. They are dealing with people's lives, hopes, dreams, families, and friends, not just a "patient".

So many doctors really care about what happens to their patients, but are shackled by the system that feeds them. Time to get back to good doctoring instead of tight business procedures. It's time for them to care enough to stand their ground and become the great doctors they can be, instead of being pawns of drug companies, management, insurance companies, and other people/things that keep them from being exemplary in their work.
3 von 3 Kunden fanden die folgende Rezension hilfreich
5.0 von 5 Sternen Pay attention to this one Healthcare providers! 11. Februar 2013
Von aidel - Veröffentlicht auf
Format:Taschenbuch|Verifizierter Kauf
This book has the potential to revolutionize the structure of the healthcare system, replacing a hierarchical approach with a team approach -- in which every member of the team is important and deserves to have his or her input taken seriously. Based on the system that many airlines have adopted, resulting in a higher degree of passenger safety, using the same cooperative style has the potential to transform and greatly increase the safety of the always changing and ever more complex healthcare system.The question is Will this book get the attention it deserves? The powers that be will be reluctant to give up their (imagined) power, no matter what the effect on patient safety. Perhaps nurses could carry this torch, just as we have done with the importance of handwashing!
2 von 2 Kunden fanden die folgende Rezension hilfreich
5.0 von 5 Sternen Excellent Resource for Making Healthcare Safer 25. November 2013
Von Beth Boynton - Veröffentlicht auf
Beyond the Checklist: What Else Health Care Can Learn from Aviation Teamwork and Safety is a well-written and well-researched book that makes a compelling case for a collaborative leadership and team development process called Crew Resource Management (CRM). CRM, explained by authors Suzanne Gordon, Patrick Mendenhall, and Bonnie Blair O’Connor was developed by the airline industry following a disturbing pattern of preventable and catastrophic taking place in aviation in the 70s and 80s that contributed to marked improvement in safety. The principles of the process are explained and there are many opportunities for adapting it to healthcare systems. As a specialist in group process consulting and a nurse, I can see great value in this work.
We can argue about differences between aviation and healthcare until the cows come home, but would miss the extremely helpful points this book clearly makes and supports with extensive references. Some highlights include but are not limited to:
* The importance of speaking up and listening in a hierarchal system where the stakes are high and the deadly consequences that can arise from obstacles that exist when that hierarchy is toxic.
* People in highly responsible leadership positions such as doctors, nurse managers, and pilots absolutely must be able to stay in charge while respecting all resources. This is a dance between leading and managing that requires expertise in one’s field of knowledge as well as communication and team-building.
* People in highly responsible team roles such as flight attendants, nurses, physical therapists, nurses’ assistants, housekeepers, maintenance staff must absolutely be able to follow and initiate change i.e. speak up with concerns. This requires an ability to follow and to be actively engaged in the process as a vital resource.
* Workload Management and the safety consequences of task saturation. It is a well-documented wake-up call about human limitations and stress.
* Safety as system-wide priority. Unless it is the true priority, over profit, over ego, patient safety will be an illusive goal. The book includes a fascinating section on how FAA regulation helped ensure safety and an alarming point about healthcare’s resistance to a similar approach. Something we should consider, if we want to provide safe care.
* Group process work, like CRM can be adapted to meet the needs of healthcare systems. (And my own caveat that ‘medical improv‘ holds incredible promise in this work because it builds the emotional intelligence and relationships that are necessary for team intelligence).

I highly recommend this book to colleagues in all healthcare disciplines including consumers in patient advocacy roles. It is filled with case studies, such as Maimonides Medical Center, (including their progressive and detailed ‘Code of Conduct’) and Osher Clinical Center for Complementary and Integrative Medicine, along with responsible research in aviation and healthcare that highlight successes and support the need for the work. The more people who read and cite this book, the more we can make a compelling case for addressing the human factors in creating safe healthcare. It is also an important book to get onto the mainstream bookshelves in educational programs for all healthcare professional studies.

The evidence already exists for making the changes we need to make and Beyond the Checklist brings it front and center!
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