How to Succeed at Failing, Part 2: Life and Death (Update)
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What personal experience changed Carole Hemmelgarn's life?
Even though the signs, the symptoms, and me as her mother kept telling them something was wrong, something wasn't right, they wouldn't listen to me. So by the time... By the time she was failing so poorly and rushed to surgery and brought back out, there was nothing they could do for her. The first harm was unintentional that they did to our daughter. It was all the intentional harms after that where we were lied to. The medical records were hidden from us. People were told not to talk to us. And the fact that it took the organization three years, seven months, and 28 days to have the first honest conversation with us, those were all intentional harms. And that's why in healthcare, we have to have transparency.
Because how many other children suffered because of the learning that didn't take place? Hemmelgarn says she filed a claim against the hospital, but she didn't move forward with a lawsuit because of the emotional toll. She ultimately took a different path. In 2021, she co-founded an advocacy group called Patients for Patient Safety U.S. It is aligned with the World Health Organization. She also runs a master's program at Georgetown University called Clinical Quality, Safety and Leadership. When harm does reach the patient or family, that is the time to really analyze what happened. And while you never want to harm a patient or family, one of the things you'll hear from patients and families after they have been harmed is they want to make sure that what happened to them or their loved one never happens again.
The example I can give for myself personally is I did go back to the very organization where my daughter died, and I have done work there. Today on Freakonomics Radio, we continue with our series on failure. In the first episode, we acknowledge that some failure is inevitable. We are, by definition, fallible human beings, each and every one of us. And that failure can be painful.
I don't think we should enjoy failure. I think failure needs to burn on us.
This week, we focus on the healthcare system, where failure is literally a matter of life or death. Some organizations felt like they had already achieved the patient safety mission. Others, it wasn't even part of their strategic plan. And we will learn where on a spectrum to place every failure. From inexcusable.
There's lots of examples of huge public sector failures, but this was one of the biggest.
To life-saving. I really believe that if we could do this, it would make a big difference in medicine. How to succeed at failing, part two, beginning now.
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