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IHI: Getting Surgeons to Embrace Safety

Cheryl Clark, for HealthLeaders Media, December 15, 2011

"I haven't been able to accomplish that goal with surgeons," said yet another.  "I'm not at an academic medical center, and I'm not at a place where, in all due respect, someone takes a checklist and that snowballs through the O.R. and all is peace and happiness and we're going to have a Kumbayah moment."

What happens when the person "who is the toughest holdout is a chief competitor, or the chief of surgery?" another attendee asked.

After the session, Richard Weiner, MD, a panel member and medical director of surgical services at Winchester Hospital, a 229-bed facility northwest of Boston, told me in an interview that he sensed a lot of frustration from those in the room.

"Trying to align and get surgeons on board with quality improvements is a major theme," he says. "They were frustrated that their efforts fell short."

And that to just say 'engage your surgeons' is just not as easy as it sounds, Weiner says. "There [are] still some surgeons who have a 'my way or the highway' attitude. There are still a few cowboys out there."

"Part of it is that when people are busy, they have the misperception that to cut out a step here or there will get them done sooner and on to the next patient. But in reality, if you eliminate steps for patient safety, not only is it risky behavior, but it's also something that could potentially take a lot longer if the wrong thing happens," Weiner says.

Healy emphasized that most surgeons today are not cowboys.

"Little by little, our leaders in American surgery are working hard to change the culture," Healy told me in a phone interview this week. "Are there pockets where you're going to have problems? That's true in every profession."

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