Returning to the AfPP’s annual Congress as a popular keynote speaker, Martin Bromiley, chair of the Clinical Human Factors Group, gave a compelling presentation on the issue of patient safety and provided an insight into the reasons why people fail to speak up, or act, to prevent disaster – even when the dangers are obvious. LOUISE FRAMPTON reports.
A well-known figure in patient safety circles, Martin Bromiley has first-hand knowledge of the impact of human factors as a result of the death of his late wife during routine surgery. A subsequent investigation and inquest found that the clinical team struggled with their nontechnical skills – such as communication, teamwork, leadership and decisionmaking under stress. Since then, he has sought to promote an understanding of human factors in healthcare – a strategy already employed in his own profession as an airline pilot. Using examples of high-profile incidents within a variety of nonhealthcare environments, he examined some of the difficulties associated with speaking up and made some comparisons within the healthcare setting.
Conforming behaviour
Highlighting the findings from a recent documentary, he explained that one of the key issues associated with speaking up arises from the need to conform. This was identified as one of the main reasons why so many people, who could have evacuated, died in the attack on the Twin Towers in New York. A number of people believed they would be safe by staying where they were in the building, which had a profound influence on others who felt more comfortable conforming to the general view. This phenomenon was further evidenced by an experiment carried out, whereby volunteers were asked to participate in a study and shown to a waiting room, where they were given notes to read about what was about to happen. What they did not know was that the experiment had already started on their arrival and the majority of other participants in the waiting room were, in fact, actors. Smoke started to pour in from the corner of the room and the subjects of the experiment became agitated. However, as the actors stayed seated and continued to read their notes as instructed, the subjects felt compelled to conform to the same behaviour. Despite the obvious danger, some even continued to hold their notes closer to their face, as the smoke had become so thick that it actually obscured their vision. In the event of an evacuation from a fire, it often takes one brave individual to break ranks and make the first step, Martin Bromiley pointed out.
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