I grew up in Boston and in the summer of 1975, I landed the dream job for a New England teenager: I sold souvenirs at Fenway Park. That summer became a memorable one for me and the Red Sox. As I watched from the stands, the Red Sox managed to win the American League Pennant and go to the World Series. I became a real student of the game that summer as I learned the subtleties of baseball. I began to better understand the "baseball as life" metaphor. While I became an insufferable Red Sox fan that summer, no one captured the metaphor of baseball as life more than Yogi Berra, the star baseball player and manager for the hated rival team, the New York Yankees. I now see Yogi's brilliance and admit that his words have wisdom for those of us in healthcare. I’d like to share some of Yogi’s infamous quotes as a metaphor for healthcare quality and patient safety.
"Baseball is 90% mental...the other half is physical." What about healthcare? I would agree with Yogi that it is about 90% mental, but would add that it is also 50% physical and 50% judgment. Bad judgment can overshadow a good skill level any day of the week. All too frequently across the country we hear about medical errors that force us to question what that healthcare provider was thinking. We can minimize events by employing simple tools such as standard protocols for common treatments, checklists for procedures such as central lines, and verification time-outs for procedures. We should be mentally and physically ready to prevent errors.
"You can observe a lot just by watching." We can learn a lot from other people's mistakes, yet often healthcare workers keep their mistakes to themselves. By doing so, the same errors continue to happen. We must be transparent about adverse events. Most are the result of system errors and we must trust a "just culture" to deal with our human errors. Reporting events and near misses into our Safety Reporting System allows us to "observe" and learn.
"If you can't imitate him, don't copy him." In technical and performance based activities, merely saying that one is capable doesn't make it so. Healthcare needs to be competency based. We must mentor each other and create minimum competency thresholds to perform certain tasks on patients. The new standards that define Ongoing Professional Practice Evaluation (OPPE) for medical staff members will help us ensure ongoing competency.
"When you come to a fork in the road, take it." Healthcare decision-making is a complex activity. We need to have input from many members of the team. Like baseball, healthcare is a team sport, and we need all team members engaged around the care plan, helping to make decisions.
"It ain't the heat, it's the humility." Many healthcare providers could benefit from using humility in our day-to-day encounters with all of the healthcare team members. Sometimes events occur when less experienced team members are afraid to question an over-confident partner on the team. Patients suffer when the team is fractured and there is poor communication among providers as a result of entrenched egos.
Finally, Yogi most famously told us that in baseball, "it ain't over til it's over." We have time to improve our performance as healthcare providers. The safety mindset is key for us to do the most important thing for our patients: DO NO HARM. There are great healthcare providers out there and we are fortunate to be working at a great healthcare system that values patient safety. We all need to keep it up.
Thanks Yogi, but Go Red Sox!
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