Distraction is Deadly

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98% 74%

Know Danger

Do it Anyway

…pilot had made and received

multiple personal calls and text

messages…while the helicopter

was being inspected and prepared

for flight, during the flight, on the

helipad…making mission-critical

decisions about continuing or

delaying due to fuel situation,

and during the accident flight.

Types of Distraction

1. Manual

2. Visual

3. Cognitive

Manual Distraction

Voice to Text

Visual Distraction

“…ambulance driver …

became distracted when he

took his eyes off the road

while reaching for a

company-issued tracking

device that fell to the floor.”

Cal Fire unit chief… “had

been texting a few minutes

before the crash and had

been talking on his phone

using a hands-free device

immediately before

the collision.”

Cognitive Distraction

Distraction Type

Texting

ON

OFF

TASK 1 TASK 2

ON

OFF

“This investigation

highlighted what is a

growing concern across

transportation – distraction

and the myth of

multi-tasking.”

NTSB Chairman Deborah A.P. Hersman.

Multi-Tasking Lie Infographic

• http://www.nsc.org/safety_road/Distra

cted_Driving/Pages/The-Great-

Multitasking-Lie.aspx

ON

OFF

TASK 1 TASK 2

ON

OFF

ON

OFF

TASK 1 TASK 2

ON

OFF

Incident

Patient

Assessment

Narrative

Signatures

Billing

Vital Signs

Cardiac Monitoring

AVPU

Pulse

RR

SpO2

EtCO2

BG

GCS

Temp

Pain

ON

OFF

TASK 1 TASK 2 TASK 3

ON

OFF

ON

“When operating heavy

machinery, whether it's

a personal vehicle or an

emergency medical services

helicopter, the focus must be

on the task at hand:

safe transportation.”

NTSB Chairman Deborah A.P. Hersman.

New York Times

Gauging Your Distraction

http://nyti.ms/qgCETw

ON

OFFDriving Train

TASK 1 TASK 2 TASK 3

ON

OFFUsing Phone

ON

OFFLooking at Paper

ON

OFFDriving Truck

TASK 1 TASK 2 TASK 3

ON

OFFUsing Phone

ON

OFFLooking at MDT

We Know…

91%

5%

9%

21%

4x

0.08

“…Secondary tasks

requiring drivers to look

away from the road ahead,

such as dialing and texting,

are significant risk factors

for crashes and near

crashes, particularly among

novice drivers.”New England Journal of Medicine 2013

F.O.S

It’s not you I worry about. It’s the crazy people out there.

“A 20-year-old woman

who exchanged a series of

text messages then crashed

into a bicyclist…

convicted of homicide

by negligent operation

of a vehicle…”

Distraction

Patient Care

Self

Partner

Community

Patient

ResponseSize-up

AssessmentTactics

TreatmentOverhaulTransport

Risk of Distraction?

“Medical error is...

any preventable event

that may cause or lead to

inappropriate medication

use or patient harm”

National Coordinating Council for Medication Error and Prevention

“Good person doing what

they think is the right

thing to do.”

“More commonly, errors are

caused by faulty systems,

processes, and conditions

that lead people to

make mistakes or fail

to prevent them.”

To Err Is Human: Building a Safer Healthcare System

Draw up and administer…

Problems With Environmental

Factors and Staffing Patterns

• Lack of space, crowded and disorganized

storage

• Poor lighting, excessive noise

• High patient acuity

• Deficient staffing, excessive workloads

Culture: How we act in workspace

Give Kids

a Script

Can I bother you real quick?

Task Interruptions

1.

2.

3.

4.

5.

Distraction

“… up to a third of the

mistakes were linked

to distractions from

avoidable interruptions.”

Medication

Safety

Zone

DO NOT

DISTURB

Paramedic

Doing

Math

Close Call

Reported 8/1/2013

No Interruption Zone

Med

Cart?

Checklist

Check

Other

read back

opportunities

Check

“Checklists and signage can

be used as reminders to

reduce distractions, and

are simple, inexpensive

tools for medication safety.”

Recruit Class Schedule

Reading Review (device free)

Ventilation Lecture (Shared Google Doc notes)

**Break**(Ins, Outs, and Inbox)

Pump Operations (Water Flow Calculations app)

Listen close to what I am about

to say...

You need to know this… Standby for

priority traffic…

I pledge to…

NO PHONE

ZONE

DISTRACTION

ANSWER IGNORE

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Focus Time

Gadgets in Emergency Vehicles

Ohio Statute

Behavior Change Opportunities

• Behind the wheel

• On scene

• In the training room

• At the dinner table

• In the patient’s home

• During transport

People Care, 2 Edition

“But when we’re caring

for their loved ones,

they expect our competence,

our undivided attention,

our concern, our gentleness

and our best efforts to keep

them comfortable and as

free of pain as we can.”People Care, 2nd edition. Thom Dick.

Will you?

• Speak up

• Change processes

• Consider a pledge

• Practice focus and refocus

• Challenge exemptions