'Mission-critical' teams, simulations help MD Anderson improve patient safety

In their search for innovative solutions to healthcare problems, hospital leaders have taken inspiration from several unlikely sources, from Disney to car manufacturers. Now Houston's MD Anderson Cancer Center, seeking to improve patient safety and standardize care, is looking to two more sources: the racing and aviation industries.

These industries have improved performance and safety via the use of hand-picked, "mission-critical" teams, and Anderson, seeking to provide the best possible care, is looking to the same strategies, Charles Cowles, M.D., Anderson's chief perioperative safety officer, told Hospitals & Health Networks in a video interview. In industries such as aviation and racing, Cowles said, success hinges on preparation and flexibility. So it goes with healthcare, he said, and "getting everybody on board with what task needs to be at hand, how to prepare for emergency and how to prepare for the unexpected [are] very important," he said.

Anderson maintains an integrated, interdisciplinary team, organized in a way that one team member can easily substitute for another if necessary. Duplicating the strategy at other hospitals would likely require considerable effort, Cowles said, but organizations should explore it regardless. "There's no reason why if a patient comes to an operating room in Houston, Texas, and we have one person assigned to attach an EKG monitor, one person assigned to help the patient move over, one team member assigned to do a timeout… that could be replicated at any hospital in the U.S.," he said.

The necessary preparation time for successfully implementing such a strategy made it a somewhat tough sell, Cowles added, but the preparation paid off, especially in crisis situations. Like airplane pilots, Cowles said, simulation exercises are vital to the approach's success, because no matter how competent the team members, they must be prepared for an unexpected crisis situation.  

To learn more:
- watch the interview

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