Autonomy

So everyone remembers me talking about the hospitals huge initiative for safety from class a few weeks ago.  How concept were being drilled into our head, concepts that directed us to pause and think before doing any procedure.  Well….we have just had our first real failure of that system and it is kinda big.  I am not going to go into details in a public forum like this, but this event that took place brought to mind this class.  The powers that be are trying to change the mindset of its members and how we approach the very serious tasks that we do.  I think the end goal of the program was hopefully to have no patient related errors in a year.  I am wondering now will the organization look at this as a failure or a learning opportunity.  Will they go back and review the event and figure out a way to learn from it.  We talked about the 4th quadrant last week, ‘measure results to capture lessons learned’ I hope the organization treats this as a results and captures the lesson rather than see it as a failure and just say don’t let it happen again.

The second thing on my mind this week also deals with the hospital but in a different way.  When we were talking last week in class about the 3rd quadrant and autonomy I was trying to apply this to my department and the hospital as a whole.  I am curious to how Dixon or some of the entities like FutureSearch would implement this in a hospital setting.  We talked about making decisions on the “line” and having the autonomy to do so.  In my lab this is something we struggle with all the time.  For example, there are procedures in our laboratory that are strict and for good reason, but as in everything emergent we have to make decisions sometimes in the heat of the moment that could save a patients life.  It may be three in the morning and we don’t have time to wake residents and supervisors up to get permission to give certain products, you just have to make a decision.  The problem with this is that if you are never allowed to participate in the decision making process in non-emergent times then how are you supposed to be able to make the best possible decision in a moment of crisis.  How does one implement antonomy in a hospital?  Nurses can’t make patient decisions but are there going to be times when tough choices are going to have to made?  The answer is yes. 

The last thing I wanted to touch on this week’s post is the concept map. For some reason I have been having a hard time wrapping my mind around the connectors and concept and I think I figured what was giving me the trouble.  I think it is that the concept map question itself has a connector in it and it was throwing me off.  I am going to go play with it and see if I can wrap my head around it a little more.

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