Conference in Philadelphia suggests new approach to medical errors

    Communication between pilots and air traffic controllers can sound like a precise, foreign language. Discussion between doctors and nurses rarely has the same specificity, said anesthesiologist Michael Appel.


    He’s a former pilot and now chief patient safety officer at Northeast Georgia Health System in Gainesville, Ga.

    Appel says the medical field should take a couple lessons from aviation. He is joining more than 1,000 engineers this week in Philadelphia at the International Council on Systems Engineering International Symposium to discuss that idea and others.

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    Systems engineers are efficiency experts, and the symposium works to promote collaboration in the defense industry, aerospace and now the biomedical field.

    Appel said he suspects that better communication could help avoid some medical errors.

    “We use such an informal system in health care for communicating critical ideas and values and orders that it’s very error prone because we don’t have a standard dictionary, standard lexicon,” Appel said. “We don’t even make an effort to do read-backs to make sure that the person on the other end actually heard what you thought the speaker meant.”

    Appel said the cacophony inside hospitals also has him worried.

    He says the machines that record a patient’s vital signs — such as blood pressure and pulse devices ― are typically programmed to sound an alarm at standard levels. Usually they cannot be adjusted based on a patient’s health or a particular situation, he said.

    “You end up having hospitals that are just a sea of non-stop alarms,” Appel said. “That has the effect of desensitizing health care workers to the sounds of alarms. So right off the bat, they’re being ignored because they’re not viewed to be relevant.”

    Appel said aviation dealt with a similar situation, but now uses an electronic system designed to only sound at the most critical times.

    Appel suggests a similar system could be applied to hospital machines.

    The Philadelphia conference is an opportunity to discuss how systems engineers can become helpful in reducing medical errors. Several biomedical interest groups are joining the INCOSE conference, a good sign, Appel said that more collaboration will develop.

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