Tuesday, August 27, 2013

Changing the Mistake Culture

Read the Article here.

Tell me something like this won't happen to EACH of us, if it has not already.

"This ER was always busy, and the administration had been pressuring us to move patients through more quickly. I examined Claire briefly and saw no worrisome signs. X-rays of her neck showed nothing wrong; I assumed she had slept wrong or pulled a muscle. So I discharged her with some pain medication and picked up the next chart in the bottomless stack.
The next morning we received a call from an ambulance transporting a female who had suffered cardiac arrest. She was brought into the resuscitation room, where we continued CPR. I didn’t recognize her at first, but then I noticed a familiar-looking son and daughter sobbing in the hallway. I looked at the lifeless patient and almost broke into tears myself. In my rush the day before, I hadn’t listened carefully to Claire’s complaint of severe headache. Now it seemed clear to me that I’d overlooked a symptom of an impending stroke."

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