THREAD: Amazing article how McLaren improved their F1 pitstop times by undertaking a deeper understanding of their teams. & how this relates to healthcare.

They used eye tracking tech to identify the pit crew wasnt focused on the car entering the pit 1/
wired.com/story/book-exc…
Once issues were identified they implemented several design and training strategies:

1. specific actions for each team member
2. train to focus on wheels
3. painted wheel nuts orange

Net result = record setting speed for pit stops and more wins. Impressive work

2/
This is the detailed approach that we must take in healthcare to get those 1% gains (and in fact, probably opportunity for 5-10%) gains.

We use simulation to help understand issues and subsequently design solutions that work....

3/
And if they don't work, that's fine. At least we've trialed them and we know they don't work before costs incurred for widespread implementation

And, sometimes what we think is the problem isn't...but requires direct observation coupled with clinician feedback.

END

4/

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More from @petrosoniak

21 Jan
THREAD: Some thoughts on trust and transparency when leading people/teams, related to recent data & report re: schools & #COVID19 in ON

For a great thread check out @DocDominik's take.

My take relates to crisis management & influencing behavior
1/ Image
I’m not qualified to comment on whether school closure should continue or not. (personally, as a parent of a 4yr old...please re-open! but not the point here)

Some considerations

2/
1. Transparency: when reports are leaked, there’s high prob for misunderstanding. Transparency in the long run is often the preferred approach (except maybe national security) but it is very true that lack of transparency fosters further mistrust.
bit.ly/397ihX8

3/
Read 16 tweets
20 Dec 20
THREAD: Spent the past 2 days co-designing & testing the #CovidVaccine administration process @UnityHealthTO using #simulation informed #design.

A huge multi-disciplinary effort coordinated by @Sim_StMikes. cc: @IrfanDhalla

Here's some insights into the process

1/
2/ Why does it matter? Somewhat self evident, but we want to design & test a process that optimizes the number of people who be vaccinated while also ensuring a pleasant & safe experience

Great clip from "the Founder"... example of design #simulation

3/ We began with core objectives/principles for the project.

This informed the blueprints for the design of the space

But we all know, things may look good on paper, but don't necessarily translate to real-life

More importantly, people's behavior can be difficult to predict
Read 7 tweets
29 Oct 20
THREAD: 5yrs ago we began the TRUST study. Excited to see it finally published in @BMJ_Qual_Saf . This kicked off my interest in using simulation to support patient safety and simulation-informed clinical design.

Here’s some thoughts & reflections

qualitysafety.bmj.com/content/early/…
2/ Study goal = identify/quantify latent safety threats during trauma ISS & analyze using framework analysis

We published other data including tracking movement within the clinical space stel.bmj.com/content/5/2/78

& debriefing content during systems sim.
stel.bmj.com/content/early/…
3/ This study was only possible with substantial support from @UnityHealthTO , our dept & @Sim_StMikes

My mentor, @HumanFact0rz taught me the importance of pitching an idea to the right people. When we started simulation for systems eval & patient safety was uncommon
Read 14 tweets
22 Oct 20
My take on TXA in TBI following an excellent review by @Kumait_Allawati @SameerSharifMD @Bram_Rochwerg & colleagues. disclosure I'm a co-author

Study objective? What is the efficacy & safety of TXA in acute TBI.

I'll provide my clinical interpretation & link to my practice
1/
There's been recent studies looking at this (CRASH 3) and one in the prehospital setting jamanetwork.com/journals/jama/…

This SR/MA provides a more fulsome look at the data including this brand new evidence.

2/
The results?

In pooled analysis, TXA likely has no effect on mortality or disability.

A few considerations when I try to contextualize the clinicaly relevance. Not all TBI are equal. GCS 3 =/= GCS 12. A SDH is not the same as SAH or EDH etc. So their are limitations here

3/
Read 15 tweets
2 Oct 20
Thread
A byproduct of the confusing #ontario govt #covid19 response is “well my kids are in school, so I can't limit my contacts, its pointless”.

This is also known as “all or nothing” cognitive distortion. Specifically, it is evaluating ones life in extremes
1/
All or nothing in reference to #covid19 behavior is "if you can’t fully socially isolate then what’s the point at all".

It's very easy to fall into this way of thinking.

psychologytoday.com/us/blog/turnin…
2/
For example, my kids go to school, so they are exposed to ~20-30 people/day. An all or nothing approach says it doesn’t matter how I socialize because I can’t achieve perfection (isolate the way public health advises) since my kids are in school.

3/
Read 6 tweets
23 Sep 20
Thread:
1/ There are growing calls for effective strategies to message to the public about risk and behavior change in the #COVID pandemic.

A few thoughts on influencing behavior. Image
2/ It’s worth reflecting on how we can influence behavior (nicely summarized in the book Switch)

Behavior is influenced by our
1.Emotions
2.Rational thought
3.Environment (designing path of least resistance)

medium.com/@jeffmarr/swit…
3/ Importantly, emotions and rational thought often compete… and emotions typically prevail. How do we capitalize on that? Image
Read 9 tweets

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