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Big Brother initiatives to improve healthcare safety

Big Brother is a term used to denote an overly controlling authority that watches over every move and action. The term was popularized way back in 1999 as an entertainment TV program, titled Big Brother, and originally created in the Netherlands. The program was based on one of George Orwell’s novels themed on continuous oppressive surveillance. Big Brother reality TV shows are now franchised in many countries and regions, sharing a common theme of continuous CCTV and audio surveillance of participants.

Continuous surveillance is not just valuable in entertainment, it is ubiquitous in the security industry. But less obvious adaptation of surveillance has always played a role in aviation safety. The so called black boxes are a mandatory requirement in commercial aircraft. They record all the flight performance data and cockpit conversations, which later become useful for investigations of aviation incidents and accidents. You can term it as a form of Big Brother, continuously recording events, albeit for safety reasons. And now, the healthcare industry is adapting continuous surveillance in attempts to reduce medical errors and improve overall healthcare safety.

To err is human, and doctors make mistakes. Sometimes the mistakes are mundane and inconsequential. But other times, medical errors end up in serious harm, or even death. Hence the push to continuously improve and learn from preventable errors. Factors that contribute to medical errors include fatigue, poor communication and an ingrained medical culture that allows errors to persist.

But Big Brother is coming in handy to help in the reduction of medical errors. A sort of a medical black box has been trialed in some health facilities. This was initially more adaptable to operating rooms where each and every action of the surgical team is monitored and recorded for subsequent analysis. It may initially seem intrusive, like all Big Brother initiatives. But the insights gained from continuous live surveillance of performance by medical teams is invaluable when things go wrong. Critical re-analysis of a recorded surgical operation can isolate sources of errors and help the surgical team to address such errors and avoid reoccurrence.

You may initially feel odd when you find cameras and microphones trained on you whenever undergoing a medical procedure. But the focus isn’t really you as an individual, but more on the whole process of healthcare. Your team of doctors, nurses, healthcare assistants and all cadre of healthcare workers are under watch as they treat you. You may worry about your dignity and confidentiality, but these shouldn’t be compromised. At the end of the day, any incidents or critical errors will be easier to review, and enhance introduction of further safety measures forthwith.

No one really likes Big Brother’s prying eyes, and ears! But in matters of healthcare safety, Big Brother has come in to limit medical errors, reduce harm to patients, and eventually save lives.

Dr Alfred Murage is a Consultant Gynecologist and Fertility Specialist. amurage@mygyno.co.ke

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