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IHI: Getting Surgeons to Embrace Safety

Cheryl Clark, for HealthLeaders Media, December 15, 2011

When Gerald Healy was surgeon-in-chief at Boston Children's Hospital a few years back, a medical student made a statement that silenced the room:

"Excuse me, Dr. Healy, I think you're operating on the wrong ear."

"That makes your day," Healy, an otolaryngologist, told a room full of physicians and hospital quality leaders at last week's Institute for Healthcare Improvement forum in Orlando.

"Trust me, when I was a medical student, if I had said that to the chairman of surgery, a professor, I wouldn't be here today," Healy said with a grimace. He was referring to the once dominant operating room mantra: “No one questions the surgeon. Not ever.”

That's not the way things work in his OR, says Healy, past president of the American College of Surgeons. "We stopped the case, we went to the record, we found that it was the correct patient and the correct ear, although that patient had some other problems in his other ear. But I asked those in the room to...give this gentleman (the medical student) a round of applause because he could have saved this patient from a very serious error."

"What it said to me was that there was comfort level in that room, they were empowered to do a better job, and that's what this is all about," Healy said.

Healy, who retired last year and is now an IHI senior fellow, said that in his OR, everyone in the room introduced him or herself and was told that if anyone was "not comfortable with what's going on," they were encouraged to speak up. All needed tools were identified so no one would have to go searching later.

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