The Blame Game Isn’t Fun

On the day after Christmas 2017, RaDonda Vaught, a neuro ICU nurse at Vanderbilt Medical Center, committed a horrific error.  Her patient was wide awake and anxious about claustrophobia caused… | Continue reading


@robpostonblog.wordpress.com | 2 years ago

The Downside of Hospitals Becoming “Highly Reliable”

Imagine you are a student watching a cardiac surgical case that went very smoothly with the exception of a few random episodes of sudden drop in the blood pressure.  Each time those ‘episodes… | Continue reading


@robpostonblog.wordpress.com | 2 years ago

Turning Safety vs. Profits into a Fair Fight

Heart surgery is a complicated procedure done on unhealthy patients. Occasional bad outcomes are easy to understand.  On the other hand, a bad outcome that was preventable is less acceptable.  Exam… | Continue reading


@robpostonblog.wordpress.com | 2 years ago