January 2006 | Back to Table of Contents
MMA Viewpoint
Warning Bumps Can Direct Us to Better Care
As I was driving from Eveleth to my home in Cloquet after the Range Medical Society’s annual legislative meeting, I encountered the first significant snowstorm of the year. The highway was covered with snow, and the wind was whipping it up, making visibility poor. I had a hard time determining exactly where the road was. Then suddenly I felt the vibration of the warning bumps along the edge of the road, which directed me back to the center. This is an example of a system that has improved the safety of driving. Just as warning bumps improve the safety of driving on our highways, systems to ensure that proper health care is given improve the safety and health of our patients.
Systems thinking is the first and perhaps most important step to improving quality in health care. As the delivery of health care becomes more complex, we need to set up systems to ensure that our patients receive all the care they need and deserve each time they come to our hospital or clinic. We can no longer rely on good intentions or memory alone to ensure that total care is given every time. We need good systems.
“The half-life of vigilance is 15 minutes,” said Josie Williams, M.D., co-chair of the AMA Physician Consortium on Performance Improvement at a recent meeting. In our busy days with ever-increasing demands to see more patients in less time, to document our history and treatment plan in more detail, including our discussion of the risks and benefits of that plan, it is easy for us to neglect to order routine tests or to complete all the steps of a treatment plan or to schedule the preventive treatment plan and immunizations that are needed. Sometimes, incomplete treatment does not have immediate consequences and problems may only show up later in a patient’s life. Other times, the consequences are serious and noticeable immediately. Airline pilots use check lists to ensure the safety of their passengers. Shouldn’t we do the same to ensure that our patients receive all the care they need?
| The MMA’s Quality Health Care Committee has identified five pathways to improving quality in health care: 1) systems thinking, 2) communication and teamwork, 3) pursuit of perfection, 4) patient-centered thinking, and 5) humility. The committee would like to expand the discussion on quality and invites comments from physicians around the state. Please share your systems improvements with MMA staff by sending an e-mail to Scott Smith (ssmith@mnmed.org). These stories will be considered for inclusion in MMA print publications and on the Web site at www.MMAonline.net. |
We must set up protocols that allow several members of our delivery team to make certain that care is completed correctly. If we can use such systems to handle the 80 percent of our practice that is fairly routine, we will have more resources, time, and vigilance to devote to the 20 percent of our patients’ problems that are more challenging. As a result, all of our patients will be healthier.
Working within systems requires a new sense of community in our health care networks. One physician trying to go it alone and not following protocols will substantially harm a system. We all must be involved in the creation of our systems so that we can all participate fully. Health care systems that decrease individual variation achieve the greatest good for patients.