Douglas Noble on Lifebox

It’s great to see patient safety getting such a prominent focus on this Christmas with support for the charity Lifebox. Lifebox’s first aim is trying to ensure a pulse oximeter gets into every operating theatre across the world. I hope we’ll all manage to give generously

The desire for safer surgery has gathered momentum in recent years, especially with the interest shown by the World Health Organization’s Patient Safety Programme. I had the privilege in mid-2006 when working with WHO of meeting with Atul Gawande’s two wingmen in a quiet corner of L-Building at WHO headquarters in Geneva. They outlined an impressive vision for a surgical checklist and within months international consensus building was underway. I always thought this drive for patient safety in surgery would go a long way, but never quite imagined just how far in only five years. Once the American drama Emergency Room had featured it in one of their episodes success seemed certain. 

Other patient safety efforts have also received prominence this year. One of the studies that resonated with the media was Swinglehurst and colleagues’ (who I confess I share an office with) study in the BMJ on the role of general practice receptionists in safe prescribing practices. 

Some years ago there was a common story doing the rounds in the patient safety community of an aeroplane cleaner who in the process of pursuing over-zealous in-cockpit hygiene found a bottle of water lodged beneath one of the pilot’s pedals. Finding and removing it could have prevented a serious accident. It highlighted an important principle: every member of the team has a role in safety. This principle moved from common hearsay to patient safety science with the publication of Swingelhurst’s work. 

Although patients have often been considered the hidden agents for safety, Swinglehurst’s research threw new light on some of the seemingly least important members of healthcare organisations. Big society may be almost politically dead, but it appears to be occurring on a daily basis in general practice, led by the most unlikely of suspects. The Daily Mail got it just right: “Let’s hear it for GP receptionists! Staff’s common sense is crucial for patients’ health.”

Douglas Noble has worked in surgery, emergency medicine, public health and for WHO. From 2006 to 2008 he was clinical adviser to the chief medical officer for England. You can follow him on twitter @douglasnobleMD