Doctor, Doctor

This one comes with a 'health warning'

The links to the process industries are a bit tenuous and the programme is 38 minutes long, but if you have an interest in manning, competence, supervision, callouts or maintenance of adequate cover then I think this BBC radio broadcast might be of interest.

File on 4 – Hospitals, open all hours?

Some of the personal stories are anecdotal, and could be upsetting to some listeners, but on the whole an interesting and balanced piece of radio.

One thing that struck me is the lack of personal authority in the junior doctors’ reluctant to call consultants out of hours. Is this due to the ‘authority gradient’ endemic in the healthcare industry or is some other cultural or even budgetary constraint at work? There have certainly been major strides in addressing the authority gradient in small teams working in healthcare, particularly ICU and operating room teams. It seems there may be some way to go outside those conditions.

The other surprising thing for me was the seemingly large effect on mortality based on the day of the week you are admitted to hospital, as well as the claimed payback time for improved consultant cover. If even part of this is achievable, we may be significantly undermanned in this safety critical area at the highest level of competence, at least in the UK.

Finally, on the topic of competence in healthcare, I was fortunate to have a consultant (the medical kind) and clinical error specialist attend my last Human Factors training course. He pointed out that it was only a couple of months ago that the NHS in England finally implemented periodic competence reviews for all consultants. Perhaps we in the process industries aren’t as far behind other industries as we sometimes think!

I think the radio broadcast is well worth the listen and raises some questions for any 24 hour operation where we have specialist support (perhaps in our case engineering or other specialisms). I’m no expert in healthcare (as you may have noticed) but I do know that this blog is read by some in the field. What do you think?

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About the author

Tony Atkinson

I lead the ABB Consulting Operational Human Factors team. I've spent over 30 years in the process industries, working in control rooms around the world, in the fields of ergonomics, control and alarm systems, control room design and operational and cultural issues such as communications, competency and fatigue. I've been blogging on diverse topics that interest me in the widest sense of 'human factors', all of which share the same common element, the 'Mk.1 Human Being' and their unique limitations, abilities and behaviours. I'll discuss the technical and organisational issues that affect safety and performance of these process safety operators and technicians and how this impacts control rooms and the wider plant. However learning comes from many places and you can expect entries about aviation, automotive, marine, healthcare, military and many other fields. Outside of work, I indulge in travel, food, wine and flying kites to keep myself moderately sane. Please feel free to post your comments on each post. Blog entries are posted with no set frequency. To ensure you don't miss out on the latest blog post, click the button below to subscribe to email alerts when a new blog has been posted.
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