BOSTON - Studies show that procedural complications are second only to medication errors as the cause of death and injury to hospitalized patients. An innovative approach at Beth Israel Deaconess Medical Center (BIDMC) is designed to reduce the likelihood of errors by making sure senior physicians are always available to observe - and help.
The Medical Procedure Service (MPS) is designed to improve upon the traditional model of "see one, do one teach one," C. Christopher Smith, M.D., writes in the May edition of the Journal of General and Internal Medicine. MPS, established in 2002, consists of senior physicians who are experts in common inpatient procedures and who supervise young doctors from what is the best way to obtain patient consent through the proper way to perform tasks such as establishing large catheter lines in central veins, or drawing fluids from the spine or abdomen, or from around the lung.
"Despite its time-honored tradition, the 'see one, do one teach one' model of procedure education is dangerously inadequate," Smith and his colleagues write. "A standardized program of teaching and evaluation allows more direct faculty observation and feedback, establishes a method to determine when competency is achieved and reduces medical errors and complications."
Pilot data contained in the study demonstrates a complication rate - traumatic organ injury, significant bleeding or collapsed lung - that is much lower than national standards. And the study found that the senior physicians were overwhelming pleased with the medical residents' competence, while the residents felt the service helped saved time, prevented complications and aided their education.