RickInOz

Hello again all,

Quite a delay since the last instalment.  Mostly due to laziness on my part and a distraction that seems to be occupying every minute of my spare time and most of my mental stamina. I’d like to report that it was a hobby, social life or other lifestyle activity, but unfortunately we’re well within the “work-related” category.

In the year since I started at the ‘Mac, various possibilities have passed in and out of my attention. Many have been relegated to the too-hard-basket, others have been de prioritised but one or two have remained fixed at the top of the agenda. The most pressing of which is “The IMPACT Project”. What started off as an interesting concept has, like many such ideas, snowballed into a barely controllable monster.

The original notion was to introduce some team-working training for the hospital’s service which attends medical emergencies. If a patients keels over, tries to expire or suffers some other catastrophe, treating staff can summon the cavalry and all will be well. Or maybe not so well. Unfortunately while medical staff, doctors in particular, are very good at sticking pointy things into people and giving powerful mind-altering drugs, they’re generally pretty crap at the basics like talking to one another coherently.

Aviation is a similarly pressurised working environment that seems to attract similarly obsessive type A personalities. The general public decided long ago that having planes fall out of the sky was “a bad thing”, so experts looked for reasons why it happened. Boeing, Airbus and others dusted off their lawyers, expecting the blame ball to be firmly chucked in their direction. However, it transpired that the weak link, the causal factor in most crashes was the squidgy thing sitting at the front. So, airlines started watching pilots intently and noticed that when things go wrong that they still remembered how to fly the planes. So it wasn’t that. Instead, when sufficient scrutiny was applied, it transpired that aspects such as communication, cross-checking, team-working and psychological flaws were responsible.

This all occurred 40 years ago when “human factors” dictated the need for “crew resource management” training. And ever since, air travel has been a darn sight safer. We’re statistically safer flying around the globe than driving to work. No matter what bad publicity Qantas might have garnered recently, you’re more likely to arrive alive travelling with them than any other form of transport.

So, bringing that back, how is it relevant to us? Well a couple of us got talking one day. The next day we started going along to attendances by our emergency teams. We noticed something striking yet worrying. For professionals who are supposed to capable of function and organisation at a high level, the tolerance of chaos was staggering. Perhaps such behaviour had become the “norm” and while embroiled ourselves, we’d not noticed. Interesting what a difference in perspective being the fly makes.

The solution seemed simple. Fly-boys have been training one another how to act and communicate as a team. Why shouldn’t we just borrow their tactics. The world will keep spinning and all will be peachy. Ah, if only it were that easy. Unfortunately medicine, more pertinently public sector medicine, demands proof. And so we’re now pushing through a multi-phase research  project involving the entire hospital. Naturally none of this comes cheap and some major scrounging is on the agenda for next year.

My computer keyboard has been glowing red-hot recently as it’s discharged 3 ethics submissions, 2 funding applications, multiple drafts of a protocol and numerous associated supporting documents. I think we’re almost there; in terms of preliminary work. The actual conduct of the project will be another 3 years of slog. But if this goes to plan we’ll save lives and maybe some of the hospital’s money too. Famine and war will still go on but there is the chance to do something truly ground-breaking here. This could be really big. Or it could flop. Sometimes researchers have to be brave.