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Plans vs Reality
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4/11/2018 at 8:29:42 PM GMT
Posts: 63
Plans vs Reality

I had some non-critical imaging done recently. During check-in there was a very nice safety related form which directed the technician(s) to review and initial about a dozen factors including the prescription, allergies, etc, each described in a full sentence or more. My enthusiasm for the form waned when I noted that at the bottom of the first page it said that this was a two page form, but the second page wasn't there.  In either case the form didn't surface anytime thereafter (that I was aware of). 


It looked to me that there was a gap between the thinking about and creation of the form and the reality of its non-use. I suspect that this is a common problem, ie that what is actually happening clinically from a safety perspective is not exactly what was planned to happen. How do you control for this? Do you audit clinical activity? How strongly is doing things as planned/designed emphasized?

4/19/2018 at 4:21:09 PM GMT
Posts: -3
We often talk about what should happen, what usually happens and what did happen when researching safety concerns.

IHI's model for improvement and the Spread articles should help control for this type of issue. If the form was evaluated post-implementation (using IHIs Model) and audits performed on the use of the form to include staff feedback that should help ensure appropriate use and adoption of the form. This sounds like a checklist that included everything....The Checklist Manifesto by Atul Gawande covers checklists quite well and suggests, "Checklists can either be DO-CONFIRM or READ-DO and must be kept between 5-9 items."

Hope that helps

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