Lean Blog Audio: Practical Lean Thinking, Psychological Safety, and Continuous Improvement

Preventing Surgical Errors: Effective Strategies Over Warning Signs in Operating Rooms


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The blog post

IMAGE: A sign that reads "CAUTION: DON'T OPERATE ON THE WRONG SIDE"

It's silly, right? I've never seen a sign like this in an operating room. And I'm not advocating for them. It's not the right approach for quality and patient safety.

If warning signs actually prevented mistakes, and given that a vast majority of mistakes are caused by human factors (like fatigue) and systemic factors (like being behind schedule because instruments were delivered late to the O.R.)…
1) A sign like this would be posted in every operating room

and
2) Wrong-site, wrong-side, and wrong-patient surgeries would never occur
But, of course, it's not that simple.
What works?
Mistake-proofing works.



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Lean Blog Audio: Practical Lean Thinking, Psychological Safety, and Continuous ImprovementBy Mark Graban

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