distraction is deadly: presentation to mn ems teaching and learning conference april 2014
TRANSCRIPT
Distraction is Deadly
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…pilot had made and received multiple personal calls and text
messages…while the helicopter
was being inspected and prepared
for flight, during the flight, on the
helipad…making mission-critical
decisions about continuing or
delaying due to fuel situation,
and during the accident flight.
Types of Distraction
1. Manual
2. Visual
3. Cognitive
Manual Distraction
Voice to Text
Visual Distraction
“…ambulance driver …
became distracted when he
took his eyes off the road
while reaching for a
company-issued tracking
device that fell to the floor.”
Cognitive Distraction
Distraction Type
Texting
ON
OFF
TASK 1 TASK 2
ON
OFF
“This investigation
highlighted what is a
growing concern across
transportation – distraction
and the myth of
multi-tasking.”
NTSB Chairman Deborah A.P. Hersman.
Multi-Tasking Lie Infographic
• http://www.nsc.org/safety_road/Distra
cted_Driving/Pages/The-Great-
Multitasking-Lie.aspx
ON
OFF
TASK 1 TASK 2
ON
OFF
ON
OFF
TASK 1 TASK 2
ON
OFF
Incident
Patient
Assessment
Narrative
Signatures
Billing
Vital Signs
Cardiac Monitoring
AVPU
Pulse
RR
SpO2
EtCO2
BG
GCS
Temp
Pain
ON
OFF
TASK 1 TASK 2 TASK 3
ON
OFF
ON
“When operating heavy
machinery, whether it's
a personal vehicle or an
emergency medical services
helicopter, the focus must be
on the task at hand:
safe transportation.”
NTSB Chairman Deborah A.P. Hersman.
ON
OFFDriving Train
TASK 1 TASK 2 TASK 3
ON
OFFUsing Phone
ON
OFFLooking at Paper
ON
OFFDriving Squad
TASK 1 TASK 2 TASK 3
ON
OFFUsing Phone
ON
OFFLooking at MDT
We Know…
91%
5%
9%
21%
4x
0.08
“…Secondary tasks
requiring drivers to look
away from the road ahead,
such as dialing and texting,
are significant risk factors
for crashes and near
crashes, particularly among
novice drivers.”New England Journal of Medicine 2013
F.O.S
It’s not you I worry about. It’s the crazy people out there.
“A 20-year-old woman
who exchanged a series of
text messages then crashed
into a bicyclist…
convicted of homicide
by negligent operation
of a vehicle…”
Distraction
Patient Care
Self
Partner
Community
Patient
Response Assessment Treatment Transport
Risk of Distraction?
“Medical error is...
any preventable event
that may cause or lead to
inappropriate medication
use or patient harm”
National Coordinating Council for Medication Error and Prevention
“Good person doing what
they think is the right
thing to do.”
“More commonly, errors are
caused by faulty systems,
processes, and conditions
that lead people to
make mistakes or fail
to prevent them.”
To Err Is Human: Building a Safer Healthcare System
Draw up and administer…
Problems With Environmental
Factors and Staffing Patterns
• Lack of space, crowded and disorganized
storage
• Poor lighting, excessive noise
• High patient acuity
• Deficient staffing, excessive workloads
Culture: How we act in workspace
Can I bother you real quick?
Task Interruptions
1.
2.
3.
4.
5.
Distraction
“… up to a third of the
mistakes were linked
to distractions from
avoidable interruptions.”
Medication
Safety
Zone
DO NOT
DISTURB
Paramedic
Doing
Math
Close Call
Reported 8/1/2013
No Interruption Zone
Med
Cart?
Checklist
Other
read back
opportunities
Check
“Checklists and signage can
be used as reminders to
reduce distractions, and
are simple, inexpensive
tools for medication safety.”
Daily EMT-P Class Schedule
Ride Along Review (device free)
Cardiac Lecture (Shared Google Doc notes)
**Break**(Ins, Outs, and Inbox)
Cardiac Meds (Drug Guide app)
Simulation (Code app)
Listen close to what I am about
to say...
You need to know this… Standby for
priority traffic…
I pledge to…
ANSWER IGNORE
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Focus Time
Injury Prevention
Group Project
Emergency Responder Exemption
• WI Distracted Driving Law ???
• MN Distracted Driving Law
– https://www.revisor.leg.state.mn.us/statut
es/?id=169.475
– “(5) in an authorized emergency vehicle while in the performance of official duties.”
Behavior Change Opportunities
• Behind the wheel
• In the classroom
• At the dinner table
• In the patient’s home
• During transport
“But when we’re caring
for their loved ones,
they expect our competence,
our undivided attention,
our concern, our gentleness
and our best efforts to keep
them comfortable and as
free of pain as we can.”People Care, 2nd edition. Thom Dick.
Will you?
• Speak up
• Change processes
• Consider a pledge
• Practice focus and refocus
• Challenge exemptions