After perusing year-end news releases, the staff at Clinic Service has compiled a list of high-profile concepts that will likely be at the center of debate about best medical practices in 2013. In no particular order, they are:
1. “As low (or as little) as reasonably possible”–in reference to dosages, radiation, or intervention, especially as cost-awareness comes to the forefront of dialogue about treatment for terminal or chronic illnesses.
2. The Three Biases: Confirmation, Pro-intervention, and Pro-technology–all of which unconsciously support erroneous conclusions or hide mistakes due to false premises. These biases are based on the unfounded (and somewhat contradictory) expectations that what worked before will work again; that it’s better to do something than nothing; and when what we do doesn’t work, then the new thing we do will work.
3. Highly Reliable Organizations–those that affect or involve a great number of people, yet cause little harm because of strict adherence to a finely delineated protocol. Hospitals and medical facilities are challenged to continually refine practices to achieve this status.
4. Sustainability (which closely relates to #3 above)—once a successful protocol has been established and its goals achieved, there remains the task of maintaining adherence to the protocol to sustain success.
5. “WHY?”–when an error occurs, focusing on why it happened instead of who or what was to blame. Answering the “why” question—even if it must be asked repeatedly about the same incident–tends to uncover more basic problems, and prevent them from recurring again, than merely assigning blame.
6. Population Health—the overriding reality in health care is literally that “no man is an island.” No one is healthy or well by himself, and what affects one person affects us all, whether it is a pandemic, illicit drug use, mental illness, infant mortality rates, carcinogenic pollution, or other insidious factors of social living that are barely recognized. A great challenge of this year will be identifying and addressing the underlying issues that affect all members of a society.