Episode 49: High Reliability with Peter Pronovost

In this episode, episode 49, I welcome Dr. Peter Pronovost to the show to discuss the high reliability movement and how it relates to healthcare.  Dr. Pronovost is one of the world’s foremost experts on patient safety and we discuss how a hospital can be as reliably safe as an aircraft carrier and how best to approach an angry patient in the ICU.

2 Replies to “Episode 49: High Reliability with Peter Pronovost”

  1. Hi,
    I am so happy to listen to your podcast it is really educational, I’m CA2 found this lecture a great resource in busy hectic residency.
    I found the EP 49 really inspiring and I hoped for a while that this will be reality. I’ve been trained overseas and work as anesthesia attending for few years, came recently and did CT anesthesia fellowship before starting again anesthesia residency.
    if may I say that since our health system is totally money-driven business it will be so hard to create a culture of empathy and caring.
    I can point to few points during my residency that is expelling residents out of this culture.
    * System based that the attending anesthesiologist double cover 2 residents or 3 CRNAs, his job turning to give breaks to each one not really take an ownership of his patients or teaching his resident gives the feel of factory style health care.
    * Overlapping CRNA with resident meaning I have to relieve the CRNA on time since his shifts ends or CRNA can relieve a resident this confusion create more and more conflict about what value of anesthesia care we are providing. (famous struggle of crna to work without Physician supervision). I believe we are not practicing best practice when attending in the room making critical decisions about pt when CRNA could give narcotic or pressors…!
    * working tons of hours and charted as 80 hrs/week to not violate ACGME rules…..getting paid 40 hrs per week per paycheck will create feeling of practicing dishonesty 24/7.
    * getting 2 breaks during a regular day 12-14 hrs work (15 mins morning/coffee break+ 30 mins lunch break) will violate any work laws.
    * So hard to find a role model in medical or mentor with all the competition pressure exist in big institution to publish more and achieve more, I would say I found less than 20% percent treat other in humane manners. other are just like machines.

    I would apologize to my honest opinion, I think to create such an ideal environment to reduce medical errors we should have a whole new set of morals running the health system.

    Really appreciate your patience.

    1. Hi there. Thanks for sharing your thoughts. I think you’ve hit on the fact that it can be very difficult to change what is a very ingrained system of training. As you point out, there are many things that we need to think about changing if we are going to prioritize well-being and reduce errors. I’m hopeful that we’ll get there, though the pace will likely be slower than we would like.

      Best,
      Jed

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