Are mistakes inevitable for overworked healthcare professionals?


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One of my patients recently suffered a catastrophic dispensing error. By which I mean not the patient-perception catastrophe of being dispensed medication that was a different colour to usual.

Instead, this was doctor-perception catastrophe of being dispensed a hypoglycaemic that he didn’t need as opposed to the anti-Parkinsonian with a similar name that he did. Ouch.

We’re yet to hear exactly what went wrong, but I’m already reserving some sympathy for the pharmacist. I’m actually amazed that health professionals don’t make more blunders, given the pressure we’re all working under – a feeling consolidated by the National Pharmacy Association’s (NPA) recent report pointing out that distractions combined with overwork are a key factor behind dispensing errors.

I can relate to that. If a surgery consultation involved just one issue without interruption, then doctors would be a lot happier and patients a lot safer. But the reality is very different.

As soon as I open the patient record, I’m confronted by a prompt cajoling me into doing this asthma review, that blood pressure check and the other Q-risk score to satisfy QOF. Then there’s a reminder that the patient’s eligible for the flu and shingles jabs. Plus a message in the journal that the patient’s due a medication review.

That’s before the patient’s opened her mouth. Then things get even worse. As soon as I type in ‘fever’, I’m automatically diverted to a sepsis protocol. I try to prescribe an antibiotic and I’m faced with a pop-up informing me that, this month, there’s a cheaper alternative. I do a statin repeat at the patient’s request and I’m asked to check that I’m absolutely certain she’s not taking amlodipine. Etc, etc, etc.

Then there’s all the peripheral stuff, such as the inevitable urgent phone-call, the internal email message and the patient’s ‘while I’m here’. So practising medicine has become like trying to solve a cryptic crossword clue while twenty different people shout in your face. And I imagine pharmacy is like this, too.

Funny that many of these distractions actually reflect innovations or impositions from the very bodies that would crush us should anything go wrong. About as funny as a low blood sugar in a patient with Parkinson’s, in fact.

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