The concept of perspective hindsight or even a premortem is not a new one and has been adopted in some beacon authorities or clear thinking healthcare institutions for some time.
Imagining what would happen if something actually properly went wrong.
For me, some years ago in the practice (when I still had a partner in the practice), I set up the system of practice guardian, something I think I need to re-visit. We appointed somebody outside of the practice who the staff could turn to if they felt they couldn’t turn to the partners. Imaging a situation where both the partners were alcoholics and drank with each other everyday. Imagine the situation now where I don’t have a partner if that happened to me. People would have to be able to go somewhere to get assistance or get help if they couldn’t approach the person in authority.
Another situation is if something serious happened to a patient and I mean serious that needed emergency assistance or care; not just a medical emergency but for me something that happened during surgery when I needed to gain access to people quickly.
All these things are worth considering when you have a quiet moment and even putting something down in writing which in the moment of crisis can help you act on thoughts you had when your thinking was clearer. Something that is introduced by Matthew Syed’s book Black Box Thinking which has been a game changer in the practice, the whole premortem thing when you analyse what might actually be the terrible incident that would occur before it actually occurs.
As I write this perhaps it should be something that goes into our staff meetings, it’s time they were re-invigorated anyway. Perhaps we’ll have a premortem every time we have a meeting, it is something worth considering for yourself.
Blog Post Number: 886
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