Through her extensive work in correctional health care risk management and patient safety Dr. Haggard developed a list of high risk practices that lead to clinical error and harm. These ten practices are discussed during the podcast.
- Failing to understand, recognize and minimize cognitive biases
- Ignoring specialist consult recommendations
- Using the word “denied” or other inflammatory words
- Failing at self-care; allowing burnout to burn you
- Lack of ownership regarding your patients and your unit
- Thinking this thought: “They’re just inmates”
- Failing to behave professionally and respectfully
- Documentation of subjective labels
- Policy and procedure violations, nonuse of modifications of standardized tools
- Falling into the premature closure trap
Although this list was originally developed with a focus on provider practice, many of these clinical practices also apply to nurses. All health care staff can benefit from avoiding burnout and taking ownership of the medical unit. We all need to behave professionally and respectfully. Like providers, nurses can fall into mental biases when evaluating patient conditions and we struggle to see our patients as humans in need of our care rather than “just inmates”.
Dr. Haggard offers these best practices to replace the above high risk practices.
- Develop skills as a “clinical reasoning expert”, understand diagnostic errors and the many cognitive biases
- Carefully evaluate specialist’s follow-up
- Frame your word choices to explain medical necessity
- Make time to care for your own needs, it takes self-discipline
- Own your medical unit – know thyself, know thy colleagues and know thy patients
- We are healthcare professionals taking care of patients
- Behave with utmost professionalism and treat others with respect
- Document objective facts avoiding subjective labels; understand affective biases
- Follow your P&P’s and make wise use of standardized tools without modification
- Understand the “thinking error” of premature closure and practice measures to minimize the effect of the care you deliver
What do you think of these ten high risk clinical practices? Share your thoughts in the comments section of this post.