Front line work environments are full of unnecessary distractions detracting focus from the task at hand. They come in many forms from a noisy vacuum cleaner disrupting a patient consult, to a poorly designed electronic medical recording system.
Dr Gordon Caldwell has presented much work specifically looking at how distraction increases misdiagnosis – see here: 1,2,3. He discusses how optimising work environments to minimise distractions leads to improved patient outcomes.
Those working on the front line understand the particular complexities of their work environments, and are best placed to conceive solutions to remove unnecessary distraction and improve efficiency.
Toyota, famous for its Toyota Production System, recognised this years ago, introducing a framework which effectively engages front-line workers in improving their work. The company implements an average of nine ideas per employee per year. This has driven Toyota to the top of the automobile industry.
Unfortunately healthcare systems throughout the world have top down frameworks which restrict improvements being made. Those making decisions impacting front line conditions are often far removed from the front line. Processes allowing the voices of front line workers to really be heard are lacking
As a result our workplaces are full of inefficiency, replete with unnecessary distractions which are almost impossible to remove.
Solutions need to be driven from the front line, assessed through simulation, and when introduced we need the ability to refine them.
If patient safety is to improve we need to be enabled to learn and improve from our mistakes.