Dr Getafix

Reasonable Faith

Another post from my first attempt at blogging, going back to late 2013. I still find Craig’s work intellectually stimulating, and spiritually encouraging today. I think my faith is even more “reasonable” now than it was 4 years ago despite, or perhaps because of, what I have been through over that time.

These days “faith” seems to be most often talked about as a polar opposite to “reason”, “logic” or “rational thought”, and increasingly, “science”. If you have faith in something then that means you believe it, but without having any objective evidence to support it. Sometimes, the insinuation by others is that you believe it even in the face of overwhelming evidence to the contrary. As Mark Twain would say “Faith is believing what you know ain’t so.”

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Patient Work

One of the (many!) things I love about Human Factors/Ergonomics (HF/E) specialists is that a large chunk of their work involves studying, describing and naming “everyday” human experiences. So when I am listening to their presentations or reading their articles, it is not uncommon for me to have an “A-ha!” moment where they describe something that is very familiar to me. “Oh, that’s what that’s called!” or “Phew! I thought I was the only one that did that sort of thing!”. A relatively recent example of this for me was as at the Human Factors and Ergonomics Society of Australia conference (HFESA17) last year. This time, the everyday experience that now had a name was “Patient Work”. Continue reading “Patient Work”

Quick Thinking and Natural Disasters

I’m currently reading Daniel Kahneman‘s book “Thinking, Fast and Slow” and while reading the chapter on the “availability heuristic”, a real-world example popped up in my news feed. To explore this further, consider the following question:

Please rank the following natural disasters in order of the number of deaths caused in Australia:
•Floods
•Heatwaves
•Cyclones
•Bushfires

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Professing Gardeners

I didn’t really get into gardening until we bought our house that had a back and front-yard that were pretty much empty slates. So I started digging around, both literally in the garden and metaphorically on-line. After a few hits and misses, I came across something that was right up my alley. It was a group of academic horticulturalists and botanists, all with PhD’s, who called themselves “The Garden Professors”. They have a blog, a Facebook group, and multiple book publications between them. But probably their most helpful resource so far has been this collection of Horticultural Myths and factsheets. The reason I enjoyed their material so much was because their main focus was to apply scientific principles and peer reviewed research to the world of home gardening, so as an anaesthetist with an honours degree in biochemistry and a new found love of gardening, I could really sink my teeth into it. I like to think of it as “Evidence-Based Gardening” (EBG)! The internet is full of gardening woo, as are many books by so-called experts, so it was quite refreshing to have some more objective input, and I quickly identified numerous mistakes I’d made by following advice from some “Garden Guru”.

However, as much as I’ve learnt from The Garden Professors, and enjoyed reading their publications, Evidence-Based Gardening (EBG) faces many of the same challenges as Evidence-Based Medicine. There are many gaps in the evidence, and often what evidence is available, isn’t directly applicable to my specific situation, whether that be rainfall, available light, temperature extremes and so on. I think gardening faces an additional challenge in that it is much harder to procure funding for horticultural research as opposed to medical research, so they are often left to extrapolate data from agriculture where much more funding is available.

At the end of the day though, gardening for me is about more than just have perfect plants and following strict rules about what I can and can’t do. So while I am keen to continue my EBG practices where possible, I will also, like medicine, remember that it is an art as well, and maybe even a little bit of woo from time to time!

These are the deadliest times for traffic collisions

This is a rather sobering infographic on road fatalities in Australia. This is a complex problem so using simple, reductionist solutions won’t work. Instead we need to use a systems thinking approach. This quote sums it up pretty well:

“We know in road safety that focusing on individual behaviour is not helpful … You actually have to change the system so that when people make mistakes they’re not penalised by dying.”

These are the deadliest times for traffic collisions

New figures reveal the most dangerous times to be on the road for young drivers, cyclists, pedestrians and other road users.

Source: www.abc.net.au/news/2018-01-25/every-road-death-in-australia-since-1989/9353794?pfmredir=sm

Rethinking the causes of road trauma: society’s problems must share the blame

Wider societal issues are driving road user behaviour, which cannot be fixed by taking a traditional road safety approach.

Source: theconversation.com/rethinking-the-causes-of-road-trauma-societys-problems-must-share-the-blame-82383

Hawaii False Alarm

The recent ballistic missile false alarm in Hawaii made headlines around the world. It was pretty quickly revealed that it occurred as the result of an employee selecting the wrong option from a menu of different options. There were two very similarly worded options, one for a “test” alert, and one for an actual alert. He selected, and then confirmed, the wrong one. Anyone who has used a computer for even a short period of time is aware of this potential error. It is rather disconcerting that a safety critical system such as this one doesn’t appear to have utilised any Human Factors/Ergonomics input or Usability Testing.

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Human Factors, Systems Thinking and Teenage Drivers

One of my areas of interest is Human Factors/Ergonomics, and in particular it’s application to healthcare. However, by its very nature, it is applicable wherever you find humans. This is a recent article from ABC News discussing it in the context of teenage drivers.

Let’s stop blaming young drivers for their deadly road crashes

As our holiday road death toll climbs, perhaps it’s time to stop attributing fatal accidents to inexperience, immaturity or even stupidity, and view the crashes as a failure in a system that should be protecting young drivers.

Source: www.abc.net.au/news/2018-01-01/road-toll-young-people-driver-behaviour-texting-drugs/9291678

Vintage Justice

Harvey Weinstein and crumbling case for ‘vintage leniency’

Source: www.smh.com.au/lifestyle/news-and-views/harvey-weinstein-and-crumbling-case-for-vintage-leniency-20171012-gyzi2e.html

Following the recent controversy regarding Harvey Weinstein’s treatment of women, the above article was one of many that popped up in my newsfeed and it includes the following quote:

“I would like to take us back to the original excuses Weinstein and his enablers, namely his now former lawyer Lisa Bloom, initially offered to manage the scandal. Why? Because they are part of a growing trend of serial sexual predators of a certain age attempting to paint themselves as “retro sexists” to whom “vintage justice” should be applied. And in doing so, they are trying to normalise the idea that there is some “new” – only recently agreed upon – standard in relation to sexual harassment and assault.”

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Breathing System Filters

The following is a report that I wrote for our Anaesthesia Equipment Committee at John Hunter Hospital in June 2017, after concerns were raised about differences in performance of different filter types, and the possible cross-contamination risks resulting from this.

Introduction

It has long been known that breathing circuits are a potential source of cross infection between patients . Of particular concern are hepatitis C and tuberculosis . Eliminating this risk altogether seems unlikely, but there is ongoing debate about how best to reduce the risk, while also being conscious of financial and environmental concerns . The use of breathing system filters (BSF) is one approach that has tried to address some of the concerns, and the presumption that they protect the anaesthetic circuit from contamination by the patient and vice versa has led to the widespread adoption of BSFs as a way to reduce cost and waste by facilitating the reuse of the same circuit for multiple patients . However the practice is not universal , and no BSF is 100% effective at preventing contamination . Furthermore, as with any piece of medical equipment, the risks associated with the use of BSFs need to be considered along with their benefits . Many manufacturers now produce circuits that are approved for use for up to 1 week as long as a new BSF is used for each patient . This is the current policy at John Hunter, with the proviso that the circuit is changed immediately if it is visibly soiled, has been used for a patient with a multidrug-resistant organism, or is excessively wet. If we assume this practice will continue, then the question that needs to be answered is which filter will best protect the circuit from contamination, and that question is the main focus of this report.

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