YOUR HOSPITAL IS @psirides

Thu June 16th

Florence Nightingale

from ‘Notes on Hospitals’

1863

#FloNi

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43

WATERBOARDING THE CRITICALLY ILL

When all you have is a hammer

Everything you see is a nail.

HOSPITAL SYSTEMS

“Hospitals are horrible places, like prisons. When you go to prison you’re given a

number. Your clothes are taken away & you’re made to wear a uniform. Then

you’re put in a confined space, not allowed to leave & have to obey orders. Finally

you’re subjected to a rectal exam.

What’s the difference?”Henry Marsh

Hospitals systems developed in the 17th century are completely

inappropriate for 21st century clinical practice

SOD VS MOD

ORTHOPOD

Hammer

Jesus Thor

Bob The

Builder

God Complex

Desire To Help People

ED

ICU

Operating Theatres

In-Patient Wards

SILO FAILURE

Healthcare is grouped by silos •Professional silos •Geographic silos •The solar-powered silo

SILOS ARE NOT BUILT AROUND PATIENTS

“There’s no such thing as the ‘surgical’ patient; there is only a medical

patient with a scar”Rinaldo Bellomo

Why do hospital systems only make staff call for help when the patient is

already dead?

MET

You can’t die without passing

through MET-

World Mortality

% Dead

*data extrapolated from current trends

How People Die

Murray et al, BMJ 2008

MET

DEC

ISIO

N T

REE

1 in 3 will have treatment limited by the MET1 in 4 will die during this hospital admission1 in 5 will be admitted to a critical care area

The treatment for dying is

probably not CPR

Be a patient in your own hospital

Q: WHY DO DOCTORS & NURSES IGNORE WARNING SIGNS BUT PILOTS DON’T?

A: THE PILOT IS ALSO ON THE

PLANE

@psirides wellingtonicu.com

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