skiddoc

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Oy vey...another dilettante sounding off.
 

michigator04

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I can't find anything Mr. Quaid said that I don't agree with. Medical errors are a huge problem, and his proposals for improvements are in line with what others in the medical field have proposed and done successfully.
 

skiddoc

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what, exactly, is your gripe with Quade?
Personally, I think he's a very likable guy, and I do sympathize with him and what he has gone through. I am even fine with him raising awareness about the prevalence of medical errors. What rubs me the wrong way is that he suggests a solution despite his, at most, superficial understanding of how "the system" works. Still, I will take a Dennis Quaid over a Jenny McCarthy any day.
 

bold text

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after reading the title of this thread i automatically assumed DQ had died:scared:
 

RogueUnicorn

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I can't find anything Mr. Quaid said that I don't agree with. Medical errors are a huge problem, and his proposals for improvements are in line with what others in the medical field have proposed and done successfully.
+1

Personally, I think he's a very likable guy, and I do sympathize with him and what he has gone through. I am even fine with him raising awareness about the prevalence of medical errors. What rubs me the wrong way is that he suggests a solution despite his, at most, superficial understanding of how "the system" works. Still, I will take a Dennis Quaid over a Jenny McCarthy any day.
didn't see the 'solution' in the posted article, and how do you know how superficial his understanding is? 'the system' isn't exactly rocket science, a dedicated person can educate himself quite readily. your post to me borders on arrogance
 

skiddoc

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+1


didn't see the 'solution' in the posted article, and how do you know how superficial his understanding is? 'the system' isn't exactly rocket science, a dedicated person can educate himself quite readily. your post to me borders on arrogance
So you agree with michigator04 in that Dennis's proposals are sound, but then disagree with me and say that Dennis makes no proposals? Right. Let's clarify what his proposals are: One of the points he makes is that making hospitals more transparent will save money and lives. Even in his particular situation, increased transparency would not have changed the way his twins were treated after the mistake was made. Could someone explain to me how transparency might work to do what he says it will do? (Please note that I am the devil's advocate).
 

RogueUnicorn

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So you agree with michigator04 in that Dennis's proposals are sound, but then disagree with me and say that Dennis makes no proposals? Right. Let's clarify what his proposals are: One of the points he makes is that making hospitals more transparent will save money and lives. Even in his particular situation, increased transparency would not have changed the way his twins were treated after the mistake was made. Could someone explain to me how transparency might work to do what he says it will do? (Please note that I am the devil's advocate).
i was really +1'ing the first line. transparency almost always leads to improvement because you can then actually see where the problem is. it's not about handling one specific case better, it's about improving the system as a whole. but that's just my opinion, i'm sure there are smarter people who can explain better. i still want to know how you're so certain his understanding is very superficial, and while we're at it, how yours is any better?
 

skiddoc

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i was really +1'ing the first line. transparency almost always leads to improvement because you can then actually see where the problem is. it's not about handling one specific case better, it's about improving the system as a whole. but that's just my opinion, i'm sure there are smarter people who can explain better. i still want to know how you're so certain his understanding is very superficial, and while we're at it, how yours is any better?

Well that's just the thing. If a pre-med doesn't know a damn thing about it (other than what my FP has told me), how can we expect anyone but a hospital administrator to know anything about it?

Before we go any further, can we please define "transparency"?
 

ucladoc2b

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Dennis Quaid might not be an actual healthcare worker. However, he brings up some very valid, supported points, and the evidence supports what he is saying.

He's not some Jenny McCarthy-like advocate who keeps beating a dead horse despite contradictory scientific data.
 
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RogueUnicorn

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Well that's just the thing. If a pre-med doesn't know a damn thing about it (other than what my FP has told me), how can we expect anyone but a hospital administrator to know anything about it?

Before we go any further, can we please define "transparency"?
i don't mean to offend you, but don't you think it's kind of backwards for a premed who doesn't know a damn thing about it to get really huffy about the supposed qualifications of a 'dilettante' who is genuinely concerned and trying to improve things? what specifically is it that you think is so detrimental about what the man is trying to do?

re: transparency, you brought it up...
 

skiddoc

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i don't mean to offend you, but don't you think it's kind of backwards for a premed who doesn't know a damn thing about it to get really huffy about the supposed qualifications of a 'dilettante' who is genuinely concerned and trying to improve things? what specifically is it that you think is so detrimental about what the man is trying to do?

re: transparency, you brought it up...
Being a dilettante implies that he's not a veteran of the process. What is needed is someone that knows the ins and outs, perhaps a whistleblower, if there's anything to blow a whistle at, that is.
 

RogueUnicorn

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Being a dilettante implies that he's not a veteran of the process. What is needed is someone that knows the ins and outs, perhaps a whistleblower, if there's anything to blow a whistle at, that is.
no, dilettante implies he's only casually interested or has superficial knowledge, which is why i asked you to show why this is the case. furthermore, considering what you have admitted about yourself, why are you proposing what should happen?
 

schrizto

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Being a dilettante implies that he's not a veteran of the process. What is needed is someone that knows the ins and outs, perhaps a whistleblower, if there's anything to blow a whistle at, that is.
Well most people in the entertainment industry are not expected to be experts on healthcare. If they are using their star power for the right cause and aren't spreading misinformation while doing it, I think it can only be beneficial.
 

dw2158

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i wish i understood his answer to the last question... what exactly has the aviation industry done re: dealing with human error? i mean, i believe that it's good because planes are so safe, but there was some handwaving in his answer and i'm very curious.
 

ucladoc2b

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Being a dilettante implies that he's not a veteran of the process. What is needed is someone that knows the ins and outs, perhaps a whistleblower, if there's anything to blow a whistle at, that is.
The problems Quaid brings up are not new. Med errors are pretty frequent, ant this is why there has been a big push over the last few years for more EMRs and computerized physician order entry.

What is needed is an analysis of the drug ordering and administration process, identification of where mistakes are occuring (or could occur), and the implementation of a redesigned process to reduce error frequency. Think about a patient being given a drug. From order to admin, no fewer than five people are involved, which leads to at least five different error points (the number is actually much, much higher btw). Multiply the number of error points times over a dozen drugs, and you can see where problems may occur.

This is, of course, a very simplified oververview. Implementing change to a very entrenched culture is a long, tedious, exhausting process. However, the results can be pretty spectacular.
 

ucladoc2b

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i wish i understood his answer to the last question... what exactly has the aviation industry done re: dealing with human error? i mean, i believe that it's good because planes are so safe, but there was some handwaving in his answer and i'm very curious.
Long answer. Aviation has embraced a very strong system of teamwork and communication. After a series of pilot error crashes in the 1960s and 1970s, aviation professionals worked to identify why crew errors occured and how they could be prevented. This led to the implementation of Crew Resource Management, which I believe was developed by United Airlines. That, combined with advanced technology, has led to some very safe skies. Pilot error-caused commercial accidents are VERY rare these days (they still happen, but they are pretty infrequent). Additionally, aviation has embraced a system of redundant checks and systems to ensure that if an error occurs, a system failure, etc that the plane is not doomed.

In the last four years, I have flown 1.1 million miles. The worst thing that has happened to me was a spilled soda during some moderate chop.

Here is some information on CRM:

http://en.wikipedia.org/wiki/Crew_resource_management

http://homepage.psy.utexas.edu/HomePage/Group/HelmreichLAB/Publications/pubfiles/Pub235.pdf

A sucessful use of CRM to over come some long ods (side note, I acutally met both Dennis Fitch and Al Haynes. They really have a fascinating story):

http://en.wikipedia.org/wiki/United_Airlines_Flight_232

And CRM and Medicine:

http://www.ahrq.gov/clinic/ptsafety/chap44.htm

Also, Atul Gawande has a chapter on airline safety in his new book The Checklist Paradox.
 
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dw2158

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Long answer. Aviation has embraced a very strong system of teamwork and communication. After a series of pilot error crashes in the 1960s and 1970s, aviation professionals worked to identify why crew errors occured and how they could be prevented. This led to the implementation of Crew Resource Management, which I believe was developed by United Airlines. That, combined with advanced technology, has led to some very safe skies. Pilot error-caused commercial accidents are VERY rare these days (they still happen, but they are pretty infrequent).

In the last four years, I have flown 1.1 million miles. The worst thing that has happened to me was a spilled soda in my lap.

Here is some information on CRM:

http://en.wikipedia.org/wiki/Crew_resource_management

http://homepage.psy.utexas.edu/HomePage/Group/HelmreichLAB/Publications/pubfiles/Pub235.pdf

And CRM and Medicine.

http://www.ahrq.gov/clinic/ptsafety/chap44.htm
really interesting. (yeah, i'm a nerd.) my googling was getting me nowhere, so thanks!
 

Jrsharp70

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Gawande writes 3 incredible books on it and nobody brings it up... It takes some Film Actors Guild member to make people decide that real healthcare reform starts with preventable errors. Awesome
 

dw2158

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Gawande writes 3 incredible books on it and nobody brings it up... It takes some Film Actors Guild member to make people decide that real healthcare reform starts with preventable errors. Awesome
let's not blow things out of proportion... someone posting a dennis quaid interview on SDN is not a sign that suddenly the world is awakening to this cause and everyone is mobilizing.

in gawande's books he talked about several different hospitals doing studies and implementing various systems to work on human error control (my memory is failing me regarding details right now) so clearly some hospitals out there were already considering these issues. maybe quaid will get more places to pay attention to this, but i doubt it.
 

schrizto

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let's not blow things out of proportion... someone posting a dennis quaid interview on SDN is not a sign that suddenly the world is awakening to this cause and everyone is mobilizing.

in gawande's books he talked about several different hospitals doing studies and implementing various systems to work on human error control (my memory is failing me regarding details right now) so clearly some hospitals out there were already considering these issues. maybe quaid will get more places to pay attention to this, but i doubt it.
agreed, jrsharp needs to chill.
 

LizzyM

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Many times, in fear of lawsuits, information about an error is held back. Changes that would decrease the likelihood that such an error would happen again don't happen because the error and its cause are kept "in house".

IIRC, the Quaid error happened because two different doses of the same medication were sold in vials that were very similar in appearance. One simple solution is to sell different doses in vials with labels of different colors. If a NICU nurse routinely dispenses drug from a purple labeled vial, the green label is going to catch her attention and she may be more likely to notice that she's got the 10 mg and not the 0.01 mg dose.

Some of the engineering that goes into airplane manufacturer and operation make it impossible to make an error and that kind of engineering is needed in medicine (e.g. couplings of various diameters so that the tubing to an oxygen mask isn't mistakenly plugged into something other than oxygen.)
 

schrizto

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Many times, in fear of lawsuits, information about an error is held back. Changes that would decrease the likelihood that such an error would happen again don't happen because the error and its cause are kept "in house".

IIRC, the Quaid error happened because two different doses of the same medication were sold in vials that were very similar in appearance. One simple solution is to sell different doses in vials with labels of different colors. If a NICU nurse routinely dispenses drug from a purple labeled vial, the green label is going to catch her attention and she may be more likely to notice that she's got the 10 mg and not the 0.01 mg dose.

Some of the engineering that goes into airplane manufacturer and operation make it impossible to make an error and that kind of engineering is needed in medicine (e.g. couplings of various diameters so that the tubing to an oxygen mask isn't mistakenly plugged into something other than oxygen.)
Ooh, that sounds like a lot of logistics involved. For example, even the colors of the vials should be carefully selected so that colorblind people can distinguish between two vials quickly, or have another identifiable feature in place other than just colors and the label. What kind of job is it usually for someone to come up with design models like these for maximum efficiency?
 

LizzyM

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Ooh, that sounds like a lot of logistics involved. For example, even the colors of the vials should be carefully selected so that colorblind people can distinguish between two vials quickly, or have another identifiable feature in place other than just colors and the label. What kind of job is it usually for someone to come up with design models like these for maximum efficiency?
. If we were really serious about safety we might require a color-recognition test as is required by the FAA. (Some people with partial color-blindness are able to pass the test.)

Keep in mind, too that the dose is printed on the label. I can recall my mother's nursing books from the 1940s with instructions on reading the label 3 times during the course of "pouring" and administering medication. It seems that some of that "old school" stuff has gone by the wayside but we should bring it back.
 

Instatewaiter

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what, exactly, is your gripe with Quade?
Seriously.

If this were how all patients who had a major medical error happen to them or their family health care would not only become much safer, but it would also lead to fewer lawsuits, more openness and the kind of health care that everyone would prefer.

Quaid saw that there was human error and chose not to pursue a lawsuit. For that alone he should be commended. He went further to create momentum to make some of the changes that we need in delivering medical care.
 

tncekm

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:thumbup: for Dennis Quaid.

He makes the point that medical errors are human errors by generally good, competent people, and suggests that we can implement protocols / make changes to greatly reduce human error. What's wrong with that?
 
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Personally, I think he's a very likable guy, and I do sympathize with him and what he has gone through. I am even fine with him raising awareness about the prevalence of medical errors. What rubs me the wrong way is that he suggests a solution despite his, at most, superficial understanding of how "the system" works. Still, I will take a Dennis Quaid over a Jenny McCarthy any day.
How is this any different from Babs Streisand lecturing at length about political issues hopelessly over her head, or a 35-year-old Hanoi Jane Fonda abetting the torturers of US troops and proclaiming that "...if you understood what Communism was, you would hope, you would pray on your knees, that we would someday become communists", or any of innumerable instances of cotton-brained celebs vociferously promoting their absurd ideals to all who will listen?

One difference: Quaid is right, and he is trying to work within the system to get change to happen rather than simply lecture the unwashed masses about what they're supposed to think. More power to him.

Besides, Undercover Blues was funny.