To improve patient safety, hospitals formally encourage residents to ask for help

More hospitals are taking aim at improving patient safety when newly minted physicians start practicing by encouraging them to call on senior physicians. Hospitals are formally doing so by implementing so-called "escalation of care" policies, according to a report from The Wall Street Journal.

For instance, four hospitals affiliated with Harvard Medical School in Boston, including Brigham and Women's Hospital, issued cards to new residents listing 15 scenarios that require them to notify a senior physician. Some of those scenarios include:

  • Unplanned intubation
  • Complication with a wound
  • Medication error requiring increased monitoring
  • A patient's first blood transfusion
  • A patient's request for an attending
  • Cardiac arrest

"We want the residents to learn how to take care of problems on their own," Douglas Smink, MD, a gastrointestinal surgeon leading Brigham and Women's Hospital's surgical residency program, said in the report. "But they also have a responsibility to escalate care."

While formally implementing this program can help residents feel comfortable asking for help, a culture change among attending physicians may be necessary for the program to be truly successful.

Dr. Smink told the Wall Street Journal older physicians need to give up on instilling the old notion that asking for help is a sign of weakness.

At the Harvard hospitals, chiefs of surgery told their senior attending physicians, "These are the things we are telling residents they have to call you for, and we really expect you are going to take the call and not bite anybody's head off," according to the Wall Street Journal.

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