I’ve Been Thinking about the need for traveling mercies on the patient-safety technology highway

June 1, 2010 | In: I've Been Thinking

I’ve been thinking about the need for traveling mercies on the patient-safety technology highway.

It’s Memorial Day weekend, and the Washington jackpot for Wednesday’s drawing is $260 million. Which reminds me of the guy who prayed all his life that he would win the lottery and didn’t. Frustrated, he asked, “Why?” God answered, “You never bought a ticket.”

Speaking of Memorial Day, this weekend marks the beginning of America’s road-trip season. Over the years, it seems I’ve heard as much about how many people are killed in vain on our nation’s highways over the holiday as I have about soldiers lost defending our country overseas.

My parents schlepped us on plenty of great road trips. Before we pulled out of the driveway, we’d pause so Mom or Dad could pray for “journeying mercies.” Neither my brother nor I remember anyone praying before our rides to school a short distance away. We weren’t sure how many miles were required for a trek to qualify for the traveler’s prayer. I’ve heard that the majority of accidents happen within a few miles of drivers’ homes.

Of course, Dad’s Plymouth didn’t have seat belts. Sweden’s Volvos got them when I was 12, but they weren’t showing up in our cars until we’d outgrown road trips with the P’s.

Last year, Volvo celebrated the fiftieth anniversary of the three-point seat belt. Safety experts conservatively estimate at least a million lives have been saved and millions more have been spared life-altering injuries.

Up until Dad quit driving a few years ago, my parents continued the practice of praying before trips. Now, on occasions when I am their chauffeur, I’d bet a lottery ticket they’re in the backseat calling on God. They also buckle up. While there’s no guarantee they’ll survive if we’re in a wreck, they know their chances are better if they couple seat belts with their prayers.

Interestingly, however, there’s evidence that some drivers cause accidents precisely because they are wearing seat belts. Feeling safer, drivers don’t feel the need to drive as carefully. In a compilation of his New Yorker articles entitled “What the Dog Saw,” Malcolm Gladwell has an intriguing section on how people handle risk, in which he notes “human beings have a seemingly fundamental tendency to compensate for lower risks in one area by taking greater risks in another.” Social scientists call it “risk compensation.”

Apparently, the same is true of pedestrians who compensate for the “safer” environment of a marked crossing by being less vigilant about oncoming traffic than if the crossing were not marked. “As economists would say,” notes Gladwell, “they consumed the risk reduction, they didn’t save it.”

As hospitals employ patient-safety technologies (PSTs), it might be worthwhile to apply lessons learned on the highway.

1. PSTs do not save lives. Using PSTs saves lives.

Some have reasoned that clinician workarounds argue against the value of PSTs. That’s akin to reasoning that passengers refusing to buckle up and being killed is an argument against seat belts. I’d say it’s a defense for wearing them.

2. When the feeling of safety leads caregivers to be less vigilant, the value of PSTs is mitigated.

Some have reasoned that risk compensation argues against the value of PSTs. That’s akin to reasoning that a pedestrian being less vigilant at crosswalks is an argument against marked crossings. Of course, seat belts don’t make drivers more alert to pedestrians. But all this simply reveals that as valuable as crosswalks, seat belts, and PSTs may be, none substitutes for vigilance on highways over Memorial Day or at bedsides in Memorial Hospital from day to day.

I pray traveling mercies for our PST journey, that risk savings earned will not be squandered.

Think I’ll buy a lottery ticket. Pray that I win.

What do you think?

Mark Neuenschwander

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