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The circulator nurse thrust her hand between the scalpel and fenestrated area demarking the surgical site. “If you’re going to cut this patient before I figure this out, you’re cutting through me.”
Needless to say, the surgeon was shocked. But he stopped.
A few minutes later, the circulator figured it out. Two patients scheduled for that morning had the same last name. The surgeon—with the support of the OR team—was seconds from performing a double mastectomy on a woman admitted for a hernia repair.
The story—as told by keynote speaker John Nance at the AHRA annual meeting in Las Vegas Monday—illustrates the power of one voice. And more to the point for the approximately 625 radiology administrators in the audience, the importance of facility leadership in creating a communication environment where that voice is not only encouraged to be heard, but expected.
“As leaders, as generals or as administrators, that’s your greatest responsibility: to make sure those voices are there,” Nance said. “That they are never intimidated—including yours—and to make sure that they are always heard.”
Nance—a retired military pilot, an attorney, and aviation expert for ABC News—spoke on the need to improve communication and teamwork in healthcare. As Nance sees it, leadership’s chief role in healthcare is to understand and implement the difference between a true team and a commander with good followers.
“A commander is supposed to know it all,” Nance said, “but a leader defines himself or herself by how well the leader can extract, orchestrate, and apply all the human talent available to that leader.”
Of course that concept can be extremely difficult to implement in any organizational hierarchy. Imagine the surgeon’s anger at the moment the nurse told him he would have to cut through her if he didn’t wait. Imagine a similar situation in the military chain of command.
Nance offered a military example of a flight training mission where the pilot was climbing toward his approved ceiling of 17,000 feet. At about 14,500 feet, the rookie junior crew officer says, he thought they were cleared to only 15,000 feet. The pilot checks with air traffic control, presuming his original perception was correct.
When air traffic control relays the 15,000-foot ceiling, the pilot desperately levels off and sees the copilot looking white as a sheet as a Boeing 747 passenger jet comes into view 1,000 feet above. Nance was the pilot, by the way.
“We would have rained people and parts all over south Seattle,” he told the audience.
Pilots in the air have roughly the same deity factor as surgeons in the OR, but Nance said the aviation world learned its lesson and began to change its ways after bad communication and bad weather led to the worst civilian air disaster in history.
“We created a situation where the captain was no longer the infallible Captain Kirk,” Nance said. “As a leader, create an environment of communication where the copilot, or whoever has something that needs asked, is comfortable— and has the obligation—to speak up and ask, if something needs to be asked.”
He also cautioned that while it seems simple, it’s not.
“It’s endemic to the human condition that we think we’re better at communication than we are,” Nance said.
That’s the reason why preoperative or preflight checklists and procedures are important protections, not just formalities to satisfy policies. And let’s face the truth that we’re all dubious of some policies (and there probably are some dubious policies). But the most important challenge is creating the environment that puts patient safety first no matter how much you do not want to irritate that doctor or hospital executive.
— Source:RadiologyTodayBlog
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