UNIT 1 – Cognitive and social skills: Errors and patient safety

Summary

This lesson discusses the importance of cognitive and social skills, in addition to medical knowledge, for avoiding errors and improving patient safety in healthcare settings.

Errors are common in complex systems like healthcare, often occurring not due to lack of knowledge but due to the complexity itself, communication issues, and problems with team management and coordination.

Cognitive and social skills complement medical expertise and are crucial for patient safety. These skills fall under the framework of Crew Resource Management (CRM) and include communication, situational awareness, teamwork, decision making, and leadership abilities.

In the lesson we analyze the successful emergency landing of US Airways Flight 1549 on the Hudson River. Despite both engines failing after a bird strike, effective CRM skills like clear communication between the pilots, seeking inputs from team members, and well-coordinated roles between pilots and cabin crew led to this extremely challenging situation having a good outcome with no fatalities.

This emphasizes that good outcomes require coordinated teamwork rather than just the skills of an individual. In the Flight 1549 case, while the captain’s ditching was crucial, the first officer’s timely reference materials and the cabin crew’s evacuation management were equally vital.

Studies have demonstrated the benefits of CRM/team training in healthcare settings. One study found it reduced severe ICU complications by 30% and avoidable complications overall. Another showed it decreased nursing staff sick leave from 8% to 3% and reduced turnover rates. An organization calculated over a three-year period, team training for 3,000 employees provided a highly positive return on investment.

In conclusion, cognitive/social skills like communication and teamwork, along with medical knowledge, are critical in improving patient safety and dedicated team training on these skills can significantly benefit healthcare organizations.