The danger month

An analysis by Andy Smith, Medical Training Magazine publisher

Every country in the world would seem to have its own ‘danger month;’ the month when newly minted residents arrive at hospitals, having passed medical school with a mostly outdated ‘assessment system,’ consisting of a written exam and possibly, several simulation exercises.

As we have mentioned before, many have never trained with the full healthcare team and may or may not have been offered any type of leadership coaching, and in many cases, have no one at their elbow to mentor them. They may have a cell number and been encouraged to use it if they have questions or need advice but equally they may regard having to call as a ‘failure’ on their part and believe it would be perceived as such by the mentor.

The damage done to an individual or team when ‘errors’ lead to the injury of a patient; let alone his or her death, can be immense and leaves long term scars and may lead to the termination of what could have been a positive career. The impact in healthcare of avoidable error and harm is arguably greater than in other sectors as personal blame is often a result.

The collective healthcare community knows what is coming year on year and collectively, regretfully, have not convincingly confronted the problem.

We all know what some of the fixes would be; training (educating is not the weak spot) new physicians in both hard and soft skills, to the latest standards of high reliability industries and providing proper assessment and mentoring for an agreed period. Making time for experienced physicians to properly support their next generation of colleagues is not easy but most non-healthcare people would argue it is essential!

There are not many high-risk tasks left solely to the newest ‘operator’ to perform. The military approach is to ensure that a newly minted officer has a grizzled NCO from whom he can learn the real job of soldiering. The airlines have the advantage of the airplane Captain, with many hours under his or her belt, mentoring the new co-pilot in a two-man cockpit crew.

Neither the young soldiers in a 30-man platoon nor the 80 to 150 passengers in the back of an aircraft, nor those who send them out to do their jobs every day, would accept any less. Why then, should patients, healthcare team members or for that matter, hospital executives, tolerate the existing ‘system’?