[two_third]<\/p>\n
Over the last few months I\u2019ve had the privilege of getting to know one of the Coalition\u2019s new individual members, Gary Fasso, and have been learning from what may seem an unlikely source of wisdom about patient safety:\u00a0 the trades.\u00a0 Gary is with the Pacific Northwest Council of Carpenters and trains the members in safe practices for when they are working in occupied health care buildings (e.g., remodeling hospitals or clinics).\u00a0 I\u2019m learning so much from him about what is transferable from construction to health care. We have recently engaged in a lengthy email dialogue from which I\u2019ve excerpted just a few points; it started with a question to him about the importance of culture: how people behave toward each other, what they believe, what the organizational and personal\/professional values are.<\/p>\n
Some very good lessons and methods (Crew Resource Management, communication, use of checklists) have been learned from aviation. While construction is heavy, immobile, and not particularly glamorous, it shares important features with both aviation and healthcare: all three are\u00a0highly technical, safety conscious, and run by fallible humans. <\/em><\/p>\n Ego: <\/strong>The first thing a carpenter does after tripping and falling on a jobsite\u00a0is to quickly pick himself up,\u00a0look around, and see if anybody saw it:\u00a0“Jeez, if I can’t make it across the jobsite without falling down, I doubt they will keep me till the end of the job.” \u00a0 Our pride should not make us a danger to others.\u00a0 Leadership should give examples of near misses or near disasters averted by a low-level operative, and \u00a0can make it clear that we are all human \u00a0and we will<\/em> do human things (misunderstandings, miscommunication, mistakes), but that we will not be terminated or retaliated against for being human or pointing out an issue. It needs to be emphasized verbally and in print, reiterated at safety meetings, and posted.\u00a0 It needs to be part of the culture of the organization.\u00a0 <\/em><\/p>\n Empowerment:<\/strong> Someone who speaks up about a safety concern and is told “You don’t get paid to think”\u00a0is unlikely to speak up again.\u00a0 The trades are training leaders to use every asset at their disposal and to be open to suggestions; this is an ongoing process, starting with Union management and the elected Union delegates, who are brought together in small groups several times a year.<\/p>\n Jobsite Safety Hazard Analysis (SHA):<\/strong> In the construction industry, every job is\u00a0different and every\u00a0task varies in some way, but if we have procedures to deal with known hazards, and to\u00a0anticipate possible dangers, it takes a lot of ego out of it.\u00a0 The <\/strong><\/em>SHA is a form that tries to cover everything that could happen on a job, and is\u00a0filled out before any work begins.\u00a0 This helps minimize on-the-spot decisions. Further, each phase or portion of the project needs an SHA due to the completely different issues encountered at the start and at the end of the project.\u00a0 Modifications are allowed and encouraged.\u00a0 <\/em><\/p>\n And an additional factor: <\/strong>A major\u00a0problem in a male-dominated field is what Gary refers to as Testosterone Poisoning. \u00a0Having more<\/em> women in the union really helps:\u00a0 a man is less likely to work unsafely if there are female workers on the crew, whether or not they are directly working together. He is also less likely to haze a woman if a female loved one (sister, daughter, or friend) has been hazed. Attitudes are changing and TP is slowly declining. \u00a0Unfortunately, Gary says that the only certain cure for TP is to suffer or witness a bad accident or \u2013worst case–a fatality. He described Tony, a veteran carpenter who came into the Union Hall very upset.\u00a0 Tony said\u00a0his crew was never much on safety, often ridiculing the safety-conscious workers until that day, when a good friend\u00a0and crew member\u00a0fell.\u00a0 The buddy was, as usual, not tied off on a safety line, and when the plywood deck gave way he fell three stories and\u00a0was severely injured.\u00a0 The crew all felt like\u00a0garbage, because they knew it was their fault.\u00a0 Tony became a Safety Officer.<\/p>\n Readers of this blog who work in health care can think of many examples and analogies.\u00a0 . Perfection is expected of imperfect humans.\u00a0 Those of us who make mistakes or near-misses often feel we cannot share them with anyone, thereby losing the opportunity for others to learn from and avoid the same thing. Many of us have witnessed, engaged in, or experienced what may be called \u2018hazing,\u2019 although in health care we tend not to call it that.<\/p>\n What really struck me was the concept of the Jobsite Safety Hazard Analysis, as I could not think of anything quite like it in health care. The closest may be the pre-procedure checklist, but I can imagine many other uses for it during a healthcare encounter:\u00a0 e.g., during the admission or discharge process.<\/p>\n I\u2019m looking forward to more conversations with Gary and learning more lessons from the trades.<\/p>\n Miriam Marcus-Smith, Program Director, WPSC<\/p>\n Thoughts for Gary<\/a> or me<\/a>?<\/p>\n [\/two_third]<\/p>\n","protected":false},"excerpt":{"rendered":"[two_third] Over the last few months I\u2019ve had the privilege of getting to know one of the Coalition\u2019s new individual members, Gary Fasso, and have been learning from what may…","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"categories":[8],"tags":[],"class_list":["post-2273","post","type-post","status-publish","format-standard","hentry","category-the-safety-blog"],"aioseo_notices":[],"jetpack_featured_media_url":"","_links":{"self":[{"href":"https:\/\/www.qualityhealth.org\/wpsc\/wp-json\/wp\/v2\/posts\/2273","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.qualityhealth.org\/wpsc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.qualityhealth.org\/wpsc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.qualityhealth.org\/wpsc\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.qualityhealth.org\/wpsc\/wp-json\/wp\/v2\/comments?post=2273"}],"version-history":[{"count":0,"href":"https:\/\/www.qualityhealth.org\/wpsc\/wp-json\/wp\/v2\/posts\/2273\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.qualityhealth.org\/wpsc\/wp-json\/wp\/v2\/media?parent=2273"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.qualityhealth.org\/wpsc\/wp-json\/wp\/v2\/categories?post=2273"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.qualityhealth.org\/wpsc\/wp-json\/wp\/v2\/tags?post=2273"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}