“A safety pause was observed” | August 2021
Following a recent medical procedure I reviewed the clinical notes in my medical chart. I read an important sentence that started, “A safety pause was observed before the procedure began.” I am a big fan of Dr. Atul Gawande – author, skilled surgeon and pioneer in patient safety – and was happy to see one of the core principles of his Checklist Manifesto guiding my care in a Boston hospital. Reading this in my chart made me feel more reassured and confident about my outcome and comfortable in the patient experience.
I also had an epiphany of sorts about my role as health navigator and patient advocate. Gawande’s checklist describes an important part of what we do – create the equivalent of a safety pause for our clients facing health decisions.
According to Dr. Gawande, an ideal checklist for any procedure – whether a medical procedure or troubleshooting an aircraft’s unstable flight – is precise, concise, practical, clarifying and efficient. In a medical context, it builds patient (and clinical team) understanding, clarifies priorities and fosters communication. Checklists in medical procedures include key decision points calling for a safety pause to confirm critical steps to proceed safely- and ensuring everyone is on the same page. A checklist is not a how-to guide but a tool to guide your work. In this way a checklist shifts decision-making from a single, centralized authority to a highly collaborative process focused on a common goal: the best patient outcome.
I realized that this safety pause and checklist approach describes my approach and core practice principle. I create pause-and-think points in the healthcare experience for clients, allowing them to clarify their priorities, understand next steps and feel reassured that health decisions align with their goals. I act not as a how-to guide but a tool to guide our work. I build patient understanding, clarify priorities and foster communication.
I have always found process and an orderly approach to thinking a source of comfort and hope I can share this with you, too.
Thank you, Dr. Gawande.
Your health information absorption rate | August 2021
Some decisions about your health are straightforward, black-and-white choices, a simple box to check with the prospect of a certain outcome. Decision-making confidently about challenging health-related matters is when things get tough. A good advocate understands this and is your partner.
One of the most important roles an advocate plays is health information management. We can slow down the firehose of medical information coming your way, apply the brakes to give you time to absorb and process what you’re hearing and make sure important decisions aren’t rushed. A good advocate can break down difficult health concepts into manageable chunks and translate for you – or others in your circle – testing for understanding along the way.
Our family’s first pediatric endocrinologist, arguably one of the best ever to practice, was a master in this skill and taught me an indelible lesson. Wearing a Disney-themed tie and greeting us in the hallway of the emergency room at Boston Children’s Hospital for the first time, I asked him the first question. “Diabetes… is that from the liver or the kidney?” His reply: “Your daughter’s pancreas has stopped working but I don’t want to overwhelm you right now. Let’s start slowly.”
A good advocate understands this – and can even ask your doctor to slow things down or ask for a pause, making space for you to ask, “What is essential to know now, and what can wait?”