I work for a patient safety technology company that runs on a simple theory. The theory goes something like this: take two proven strategies that we know work, marry them, and give them to patients and their doctors. The two strategies are safety checklists, and engaging patients in their care. We know safety checklists work – any engineering industry will affirm that, and when Peter Pronovost, one of our company’s co-founders, applied it to healthcare, medical error reduced significantly. What hasn’t been tried is getting patients and their families to use them. So right about now is when we often get the question, “Hold on, why should patients be the ones using checklists? If I’m on an airplane, do I really want the passengers wandering into the cockpit with a smartphone, asking questions and telling the pilot what to do?” Ah, the airplane analogy. This is one that is made repeatedly in healthcare. But let’s pause a moment to consider this analogy and all the ways it plays out.
First, it’s probably safe to say that most people flying have flown before. It’s not an uncommon experience. They’ve been to airports. They know how much time to allow themselves to get to the airport, to allow for security screening, and to board. Once they are on the airplane, they are familiar with the procedures and what to expect. They know, for example, that the pilot is not going to walk into the cabin and greet them. Rather, he or she is going to fly the plane. The cabin crew will greet the passengers and take care of their needs while flying. In healthcare, many people have never been to a hospital to have surgery or a medical procedure. Upon arriving at a hospital for a surgery or medical procedure most people are not familiar with the environment, they don’t know what to expect, and while they may know the difference between a nurse and a doctor there are a lot more people in a hospital than crew members in a plane.
Second, most people know how to plan a trip. They know what to pack, how to check the destination’s weather forecast and passport or visa requirements. If they are going on a vacation, they think about planning transportation to and from the airport, scheduling time off from work, arranging for the neighbor to take care of their dog while they’re away, and other logistical details. In healthcare, many people will be having a particular surgery for the first time. Many people do not know how long the surgery will last, how their life will change after the surgery, if they have an option to choose from different alternatives like an invasive vs. non-invasive procedure, or trying exercise and physical therapy before having the surgery. Other details like the amount of time off from work, post-surgery physical ability, pain management and wound care are important to manage for a successful surgical recovery, but again – are not well-known or intuitive.
So, here’s another contrasting fact between air travel and medical procedures performed in hospitals. By all reasonable summations, flying is a safe activity. The odds of being killed on a single airline flight are 1 in 4.7 million. In healthcare, the skies are not so friendly. In fact, the rate of preventable error is currently the third leading cause of death in the United States. Between 250,000 and 400,000 people die every year because of a human error in the healthcare system. This is equal to two Boeing 747s crashing every day in the US. According to the Agency for Healthcare Research and Quality, one in every seven Medicare patients will be harmed by a medical error.
With that said, patients need checklists. If we started taking our hospital visits just as seriously as we do our upcoming vacations, there is a lot of science that predicts we’d get safer and better outcomes. When we plan a vacation we are involved mentally and emotionally because we’re focused on the outcome: getting to our destination, and enjoying that destination. We plan carefully, we budget carefully, we make lists, we usually bring a friend or loved one with us. All of these actions, if transferred to the healthcare setting, not only would save lives but would make the patient experience far less stressful. When a patient steps into a hospital for surgery or a medical procedure, they are literally putting their life into the hands of the healthcare team at that hospital. If there is ever an appropriate time and place to express our needs and preferences, to engage in our care, to partner with the clinicians on our team to ensure that everyone “gets to city B” safely and smoothly, that is the time and place.
So whether you’re a Lonely Planet or CondeNast traveler, if you or a family member has to plan a trip to a hospital, take it seriously. In the same way that anyone – whether they’re a college student or a retiree or a mid-career professional – can plan out every hour of a trip to a foreign city like Tokyo using a New York Times “36 Hours in [choose your city]” article, companies like Doctella are providing patients with the disruptive tools and technology to take ownership of their healthcare choices and plan their hospital journey.