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Promoting Teamwork and Communication
The Medical University settled for $950,000 without a lawsuit. A portion of the money was plowed into Mothers Against Medical Error, an activist group founded by Helen, who now works full-time as a patient advocate. Her efforts led to the passage, in 2005, of the Lewis Blackman Hospital Patient Safety Act, which requires all physicians in South Carolina to wear identification describing their rank. Hospital staffers must also call an attending physician if a patient asks. "It would be hard to do anything else," says Helen of her ongoing patient activism. "You're sort of driven by the Furies."
Fatal hospital mistakes on the night shift cost lives, careers and millions of dollars in legal fees, boosting health care costs at a time when many Americans can barely afford to get a cavity filled, let alone pay for necessary surgery. So several schools, including those at Villanova University and the University of Florida, are developing computer analysis programs that allocate nursing staff where they're needed most. Other experts are grappling with the medical establishment's lumbering hierarchy, considered by many to be outdated in a time when life-and-death decisions must be made with lightning speed.
Instilling the value of teamwork begins in medical school. At the University of Minnesota, the schools of medicine, nursing and pharmacology are all on one campus to facilitate interaction. The students participate in simulated high-risk scenarios set up like contests. "To succeed, they have to know what the other people on the team are doing, and how to communicate," says Dr. Carol Ley, chairman of the University of Minnesota Medical Center's board and director of occupational medicine at 3M Company. Dr. Ley has firsthand experience with medical error: Her seven-year-old daughter, Jacquelyn, could have died after a morphine pump was mistakenly set too high. It happened during the night shift, following surgery for a shattered elbow; fortunately, Dr. Ley, spending the night in her daughter's room, noticed Jacquelyn was barely breathing. She puts it bluntly: "The night shift, with its hand-offs and staffing issues, is prime time for medical error."
In South Carolina, the Medical University recently endowed a professorship called the Lewis Blackman Chair of Patient Safety. The first Lewis Blackman professor is an expert in simulation training who will oversee a center at Greenville Memorial Hospital, where Lewis was born, as well as six others. Dr. Jerry Reves, dean of the college of medicine at MUSC, says the new program is a bold statewide initiative that will train medical students and nurses to manage simulated crises. "It's a fundamentally different way of approaching medical education," he says. "The old way was, See one, do one, teach one. This way, you don't get out of it until you've proven you can actually manage it, even if it takes a hundred times."
In Houston, burn victim Cornell Morton is making slow progress. "But my balance is still off, and I feel like an arthritic person," he says. Four years after his accident, he continues to live the nightmare of the hospital night shift. "I'm in bed at nine and up by midnight, usually for three or four hours," he says. "I haven't slept five hours straight since 2003."
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