Sunday, January 27, 2013

Need for reappraisal of notion of errors in healthcare

Very good article by Sonja Jerak-Zuiderent argues that patient safety needs to be conceptualised in terms of 'living with uncertainty' rather than errors in healthcare. Errors do not necessarily detract from safety and to ensure safety it is important to allow for the possibility that errors will occur. Practitioners live with uncertainty and a margin of error will always occur in their practice. This is not being complacent about iatrogenic damage and harm which is a major concern.

It is problematic to assume that safety will follow from protocols designed to reduce errors. In fact, safe practice requires an openness to change and the need for new responses. Creatively understanding what safety means in a specific instance can even require disregarding established protocols or guidelines. Assuming that safety will follow from protocols loses the benefit of living and acting in the real world. Mistakes need to be valued as a core element of life itself. Living with uncertainty does not mean that anything goes or that one is complacent about errors and is a safer mode of clinical practice.

Sunday, January 13, 2013

Sir Jimmy Savile groomed an entire nation

Excellent article in The Telegraph by a freelance journalist who has covered child protection issues, realising that she'd been "hoodwinked" [her word] by Savile on the set of 'Jim’ll Fix It’. She was dumbfounded by his hand licking and crude patter. I suppose from his point of view, however unconsciously, he dealt well with his physical repulsiveness. Quite an achievement to be "not far off being England’s very own Mother Teresa". Paedophiles may not be "everywhere" but they are widespread, and they may not be "impossible" but they are difficult to detect.  As I've said in a previous post, the government needs an independent inquiry to look at these wider societal issues.

Thursday, January 03, 2013

HRH is a post-modernist?!

JRSM article by Prince Charles talks about his integrated approach to medicine and health. Includes too much of the spiritual and complementary for my liking but at least he quotes George Engel (eg. see previous post). And HRH knows that his is a wider definition of integration than is commonly used, so hopefully he won't undermine such an approach. However, he seems to have been taken in by psychoneuroimmunology and stress causing shortened teleomeres. The overenthusiastic  optimism of Paracelsus doesn't justify HRH's promotion of the irrationalism of alternative medicine.