It took three generations of flight training for checklists to become an essential part of aviation.
Note that a flight-training generation is less than a human reproductive generation; it's the time from first lesson taken to first lesson taught (plus some). It had to wait for the older instructors to retire.
We are still in transition, in medicine. Many physicians have not yet cottoned to hand-washing, yet.
I don’t know about that last part. My dad is a fairly old physician and the way he tells it hand washing has been mandated by the feds for decades and the last cohort of old docs who refused to change in that respect retired circa 1990. But the culture may be different in other parts of the US or world.
- The CEO's semi-monthly emails have either contained a) reminders to get the flu shot in flu season and b) statements about washing hands.
- Thirty minutes of your new employee orientation is used to discuss handwashing with some funny stories about diarrhea and they go around to every single person to make sure they're washing them correctly.
- Upon entering a patient room, anyone entering is supposed to wash their hands
- Anyone can call out a doctor and ask if they've washed their hands and there are signs to make patients comfortable asking them to do so as well.
So yeah, 2019 and people still need all that as reminders.
I liked how in Freakonomics (I think), they interviewed someone who worked at a hospital, and would regularly and randomly take culture samples of nurses' and doctors' and administrators' hands. The results of the culture were shown on a screensaver.
This feedback and public transparency was both amusing, and enforcing of the necessary handwashing.
Among this cohort, the mean self-estimated handwashing rate was 73% (range, 50%-95%), compared with the covertly observed rate for this cohort of 8.6% before and 10.8% after patient contact, with an individual mean rate of 10% (range, 0-33%).
I liked how in Freakonomics (I think), they interviewed someone who worked at a hospital, and would regularly and randomly take culture samples of nurses' and doctors' and administrators' hands. The results of the culture were shown on a screensaver.
This feedback and public transparency was both amusing, and enforcing of the necessary handwashing.
Maybe -- and this is just my own opinion/speculation -- this is because in my lines of work, the results of failing to follow a checklist can be at worst catastrophic and relatively immediate. In medicine, some classes of failures might be more subtle and harder to notice.
Anyone with medical knowledge, feel free to inform me if that idea is totally off-base.
Also in medicine, it's often not the practitioner who suffers the consequences, which even if we ignore the moral aspects, means the feedback loop isn't closed tightly, making learning more difficult.
Comments
It took three generations of flight training for checklists to become an essential part of aviation.
Note that a flight-training generation is less than a human reproductive generation; it's the time from first lesson taken to first lesson taught (plus some). It had to wait for the older instructors to retire.
We are still in transition, in medicine. Many physicians have not yet cottoned to hand-washing, yet.
I don’t know about that last part. My dad is a fairly old physician and the way he tells it hand washing has been mandated by the feds for decades and the last cohort of old docs who refused to change in that respect retired circa 1990. But the culture may be different in other parts of the US or world.
Currently work at a hospital.
- The CEO's semi-monthly emails have either contained a) reminders to get the flu shot in flu season and b) statements about washing hands.
- Thirty minutes of your new employee orientation is used to discuss handwashing with some funny stories about diarrhea and they go around to every single person to make sure they're washing them correctly.
- Upon entering a patient room, anyone entering is supposed to wash their hands
- Anyone can call out a doctor and ask if they've washed their hands and there are signs to make patients comfortable asking them to do so as well.
So yeah, 2019 and people still need all that as reminders.
I liked how in Freakonomics (I think), they interviewed someone who worked at a hospital, and would regularly and randomly take culture samples of nurses' and doctors' and administrators' hands. The results of the culture were shown on a screensaver.
This feedback and public transparency was both amusing, and enforcing of the necessary handwashing.
Ah... you're in for a nasty surprise. [1]
Among this cohort, the mean self-estimated handwashing rate was 73% (range, 50%-95%), compared with the covertly observed rate for this cohort of 8.6% before and 10.8% after patient contact, with an individual mean rate of 10% (range, 0-33%).
[1] https://www.mja.com.au/journal/1996/164/7/teaching-hospital-...
I liked how in Freakonomics (I think), they interviewed someone who worked at a hospital, and would regularly and randomly take culture samples of nurses' and doctors' and administrators' hands. The results of the culture were shown on a screensaver.
This feedback and public transparency was both amusing, and enforcing of the necessary handwashing.
Maybe -- and this is just my own opinion/speculation -- this is because in my lines of work, the results of failing to follow a checklist can be at worst catastrophic and relatively immediate. In medicine, some classes of failures might be more subtle and harder to notice.
Anyone with medical knowledge, feel free to inform me if that idea is totally off-base.
Also in medicine, it's often not the practitioner who suffers the consequences, which even if we ignore the moral aspects, means the feedback loop isn't closed tightly, making learning more difficult.
What?!? How many generations has it been since Louis Pasteur?
Actually, Ignaz Semmelweis.
And about 150 years, so 4-5 generations of surgeons. Not exactly many.
Surgical generations, like pilot generations, are quite a lot shorter than reproductive generations.
I have bad news for you. I have been seeing a lot of doctors for the last five years or so.
Two or three are absolutely fastidious about hand washing.
The rest are not.
This isn't really true. They know it's important.
1) Have you ever washed your hands 12 times a day for a week? Think about what your hands would be like.
2) Washing hands properly takes somewhere around 2 minutes. That's a significant fraction of an hour--just spent washing your hands.
Given this, disposable gloves seem like a much better answer.