What the Nuclear Industry Can Teach Healthcare About Peer Review


Healthcare Organizations Can Learn Peer Review Protocol from Industry

What do mattress factories, nuclear plants and the airline industry have in common? They demonstrate a high level of operational efficiency which sets an example for healthcare and peer review. Accountable care is the new reality that is forcing healthcare organizations to concentrate on standardized best practices and to become more efficient at medical peer review. But the healthcare industry is trapped in an old model and accepting innovation is tough.

Mattress Factory Plans for the Unexpected

Not finding answers in their own field, as reported in Health Imaging, some healthcare organizations have stretched their nets further out into other industries to find new blueprints for success.

Visiting a successful Japanese mattress factory, Seattle Children’s Hospital’s surgery team learned to plan for the unplanned by creating space for the unexpected ahead of time. For example, by creating space on one surgeon’s daily schedule for central line requests the team reduced the number of procedures needs and therefore cut in half the number of sedations required for children.

Nuclear Power Plant Embraces Culture of Learning

Finding inspiration for quality peer review from nuclear power operations, Peter J. Pronovost, MD, director of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine, noted that their peer review could be applied in healthcare.

After the Three Mile Island nuclear power plant accident, the newly formed World Association of Nuclear Operators (WANO) developed a voluntary peer review process. Unlike regulatory reviews, which are often judgmental and carry the threat of shutdown, WANO reviews embrace a culture of learning, says Pronovost. Visiting operators detail their findings from site visits but don’t share their findings with anyone outside of the nuclear plant under observation.

Catching on to Checklists from the Airline Industry

Utilizing checklists, the airline industry makes sure that pilots and their crew perform all vital tasks before takeoff. “Healthcare caught on to the checklist concept 10 years ago, 70 years after aviation adopted it,” says Robert J. Szczerba, PhD, corporate director, healthcare initiatives at Lockheed Martin in Oswego, N.Y.

According to Szczerba, healthcare has been slow to using checklists because providers’ incentives differ from airline pilots. Every time an airplane takes off, the pilot and crew face the same risk of death as passengers, so they are motivated to follow a checklist of simple basic safety procedures that reduce the risk of operator error.

While everyone on the healthcare team wants to make sure everything is done correctly for patients, someone may be tired or rushed, which can lead to preventable errors. “The same incentive isn’t necessarily there,” Szczerba added.

What has your healthcare organization learned from other industries? Please share your stories via the comments section below.

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