The World of Zero Risk

Everyone knows how important safety and quality assurance is in health care delivery.  I find thinking and talking about this stuff as boring as batshit, even though their objectives are obviously worthwhile.  Most of the "thinking" in the area seems to revolve around approaching the health care service as a system and examining its component parts like a car engine.  Zzzzzzzzzzzzzzzzzzzzzz..............  This, with EBM its close ally, can hopefully lead to some sort of uniform response being recommended for a particular situation.  Also, you should always be very careful.

The endeavours are indeed worthwhile and have done enormous good for patient care over the years.  But could they be done better?  Sometimes I've found their actual products, the protocols and clinical pathways unhelpful or even stupid.  Too vague or too restrictive to apply to the particular case in front of you, or trivially obvious in their focus.  

This French dude was interviewed on ABC radio and this is the first time I've heard anything on the topic which sounded mindful of the realities of clinical care as well as not making me want to remove my ears and place them in a saucer of acid after a minute's listening.  Maybe go the transcript, his accent's pretty strong.

I've thought before that the chiding we often receive for health care being "decades behind aviation" in QA etc to be vacuous, and the part where he basically describes pilots as slow learners who don't cope when the shit goes down is awesome.

Some key points he makes are that protocols can be good or they can be dangerous, that medicine is naturally attuned to dealing with the "unexpected" which is partly why our management of routine tasks is often poor and that innovations in medicine have faster turnover than in wussy jobs like aviation, making uniform approaches to safety less useful.

Swan's interviewing is f*cking hopeless, he strives to box the dude into the established orthodoxy of protocol worship, the dude announces he's going to describe 3 "gold strategies" for their use and Swan just has to interrupt him after 2 with his brainless nattering.  When he got to the Great Medication Error Catastrophe of the Modern Era I prayed that the dude would administer his microphone in the French way (did you know that medication errors cause over 60% of all deaths in developing countries and that without them average life expectancy would be 115 years blah blah blah blah blah blah blah blah?).

So I'll have a look at dude's work myself and get back to you.