1st round of chemo complete and no significant side effects and slept well. Work with dry mouth and a slight headache. So far so good. Another four days of this to go.
Talked with the doctor team. It’s good to see the nurse joining in so that she is properly briefed. Also, so I don’t have to say the same things twice. Talked system safety with Stephanie who recognizes the contributions of aviation safety to medicine.
It’s important however, to distinguish differences between aviation and medicine, and avoid a one-size-fits-all solution. Jim Reason has written extensively about the differences, so I’ll try to avoid repeating. But first, obviously there is so much more attention paid to the customer in medicine than there is in aviation, and, for the time being, cost of care, although importent, is not nearly as critical a factor in medicine as in aviation.
Other differences, pointed out earlier, are that medicine is not overseen or regulated in the same manner as aviation. It’s not clear that it needs to be. The DF model of system safety introduced after the Betsy Lehman accident, and the “To Err is Human’ report seems to work well here. The question is, how well does it work at other hospitals? This is an area where I think there is a need for self-monitoring, something, I think, that IHI is working on, that would allow hospitals to report incidents, accidents, and near misses, and do trending and root cause analysis. Judging by what I read, DFBWCC is rare for having an explicit system safety program, and other hospitals are either in ignorance or unable to afford it. One of the roles of the system safety advocate, therefore, should be to encourage the hospitals to adopt a system, and show it can be implemented incrementally.