Anesthesia Patient Safety Podcast
The official podcast of the Anesthesia Patient Safety Foundation (APSF) is hosted by Alli Bechtel, MD, featuring the latest information and news in perioperative and anesthesia patient safety. The APSF podcast is intended for anesthesiologists, anesthetists, clinicians and other professionals with an interest in anesthesiology, and patient safety advocates around the world.
The Anesthesia Patient Safety Podcast delivers the best of the APSF Newsletter and website directly to you, so you can listen on the go! This includes some of the most important COVID-19 information on airway management, ventilators, personal protective equipment (PPE), drug information, and elective surgery recommendations.
Don't forget to check out APSF.org for the show notes that accompany each episode, and email us at podcast@APSF.org with your suggestions for future episodes. Visit us at APSF.org/podcast and at @APSForg on Twitter, Facebook, and Instagram.
Anesthesia Patient Safety Podcast
#227 Technology's Impact on Patient Safety: Insights from Filmmaker Mike Eisenberg
Join us for an enlightening conversation with documentary filmmaker Mike Eisenberg, where we explore the transformative role of technology in patient safety, inspired by his acclaimed film "The Pitch." Discover how pioneers like Jeff Cooper have shaped anesthesia patient safety and learn how the world of aviation offers valuable lessons for the healthcare industry. We promise you'll gain insights into how embracing technological innovations can not only reduce complications and costs but also improve safety outcomes across the board. You'll hear about the fascinating parallels between industries and the potential of predictive analytics to preemptively tackle issues like low blood pressure during surgery.
In our discussion, we highlight the power of collaboration and storytelling in driving change within healthcare systems. We highlight the significance of dedicated events such as Patient Safety Awareness Week and World Anesthesia Day in bringing often-overlooked topics to the forefront. This episode underscores the collective effort needed to address patient safety issues, likening it to the global challenge of climate change. Listen in to understand the pivotal role of media and technology in shaping a safer future for patients worldwide.
For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/227-technologys-impact-on-patient-safety-insights-from-filmmaker-mike-eisenberg/
© 2024, The Anesthesia Patient Safety Foundation
You're listening to the Anesthesia Patient Safety Podcast, the official podcast of the Anesthesia Patient Safety Foundation. We're bringing you the very best from the APSF newsletter and website, as well as the latest information in perioperative patient safety. Thanks for joining us.
Speaker 2:Hello and welcome back to the Anesthesia Patient Safety Podcast. My name is Allie Bechtel and I'm your host. Thank you for joining us for another show. Last week, we left the operating room for a trip to the movies to talk about the Pitch, a documentary about the intersection of patient safety and technology. Time for a popcorn refill as we continue our conversation with the filmmaker Mike Eisenberg today. Have you seen the Pitch yet? If not, we hope that it is on your watch list, since this documentary is all about the evolving role of technology in improving patient safety across medicine.
Speaker 2:Before we dive into the episode today, we'd like to recognize GE Healthcare, a major corporate supporter of APSF. Ge HealthCare has generously provided unrestricted support to further our vision that no one shall be harmed by anesthesia care. Thank you, ge HealthCare. We wouldn't be able to do all that we do without you. Check out the show notes for more information about Eisenberg's patient safety films. The first film To Err is Human and his more recent one, the Pitch. You can find information about how to stream the films and a schedule for upcoming screenings. If you are interested in patient safety, then these films are for you.
Speaker 2:Now it is time to sit back, relax and listen to the rest of my conversation with documentary film director Mike Eisenberg. Anesthesia professionals are often being asked to do more with less. Like, do more cases with less people who anesthesia professionals who are able to do the cases. But you know we often talk about it on this podcast and we have articles in the APSF newsletter about how actually what is safer for patients is also usually saves money. So because it reduces complications, reduces hospital length of stay, and so it's just. It's always very interesting because we think, well, if we just do the safer thing, that actually will save hospitals money, which is what they want, and it achieves our goal of providing safer patient care.
Speaker 3:It really does. It's hard for me to say that because I'm from the outside and nobody wants to hear me say that, but it's the truth and when that conversation comes up I jump at it because yeah, I mean, there are certainly examples of this ROI being worth it and maybe you know it just depends on how you see the system. If you think inherently the system of health care is corrupt, you're gonna see it as, like everybody has their own built-in presumptions and feelings about the health care system in america. Sometimes it's it's brought on by things that have nothing to do with this, like an insurance scam or you know something that they encountered. But at the end of the day it's a business and you have to make the business case.
Speaker 3:I think Rotam does a great job in the film of talking about that and a lot of the conversations that have come up after the film at panel discussions that I've been at, I've seen that be a topic of interest. You know, when we first started filming, actually one of the first interviews we did was with Jeff Cooper, who's a big, you know, name in anesthesia patient safety history, and he had some amazing insights and unfortunately it didn't make the film because we were at the very beginning of production and we had to sort of follow the narrative threads that we took and couldn't spend as much time on anesthesia as I think actually we would have liked Got a lot of good stuff sitting on the editing table. But he really had some amazing insights on the history of patient safety and how much anesthesia was really at the forefront of the movement before it became popularized by the Two Errors Human Report in the late 90s, and I thought it was really interesting to hear about how the tools that sort of led to some of these revolutions in patient safety around anesthesia were not coming from an intent to make anesthesia specifically safe right. To make anesthesia specifically safe right. It was like it was studying the effects of anesthesia, the effects of the processes of doing it, and using tools of the era to calculate these things. And then it started. It's sort of like the all the inventions you hear about it. They were trying to solve one problem and ended up solving another and I think that that's the. That's the thing that's happening in healthcare today.
Speaker 3:When in the film we do this too, we talk about how other industries are using technology in certain ways, healthcare could learn from these other industries and adapt those ideas to make healthcare safer.
Speaker 3:It really has to. I think it has to come from that approach now I think it's been what 25 years since the Two Heirs to Human report and some progress has been made, but clearly not enough, and a lot of it is just this cycle that's ongoing of people asking the same questions, going to the same meetings, doing it the same way. And now that we're in an era of technology where other industries like the automobile industry or the aviation industries have really incorporated technology with the focus on safety, healthcare has got to do the same thing. They just got to do it and can't be afraid to change things up. You just have to do it in a smart way. You can't just throw things at the wall, and I think that's why the process of having to do clinical trials is good, but it's tough and it probably wears a lot of great innovators out, because it's a much more rigorous process to get an innovation adapted by healthcare than it is in some other industries.
Speaker 2:I definitely agree with. Turning to other industries In anesthesia in particular, we've used a lot of examples from the aviation industry to try to improve anesthesia patient safety and even we, just the Anesthesia Patient Safety Foundation, had an article earlier in 2024 called From Glass to Mask, and it was drawing on the experience of abstaining from alcohol for pilots before they fly and asking the question is this what anesthesia professionals should also? Should they also have a timeframe from glass to mask, have a timeframe from glass to mask, thus from an alcoholic drink until they have to provide anesthesia? But it was very interesting just linking up the aviation industry to what anesthesia professionals do.
Speaker 3:Yeah, and I remember that from the first film, where we focused on anesthesia a bit as well, but did it sort of within that context of how the aviation industry, checklists for surgeons and other things have really been adapted, as well as the training tools and simulation techniques of aviation. Aviation, it's all over. It's tough, though. The problem in healthcare is hospitals don't work together. And sure why would they right? They're competition usually, but, sorry, I kind of feel like it shouldn't be that simple, and the fact that agencies like AHRQ in DC, which is massively underfunded, is the one or certainly they're really responsible for everybody finding out these success stories from other places, and it doesn't work. It can't work if it's only their responsibility.
Speaker 3:When a hospital in Boston has all these resources to do something with technology and then finds that that has succeeded in solving some sort of patient safety issue, those success stories should be shared everywhere. And, yeah, a lot of hospitals in the country don't have those resources and they are responsible for a 500-mile radius or something of people who don't have the choice. Where Boston, you can choose from one of three hospitals, never mind the insurance issues. I'm just saying, though, that big cities, opportunities are bound there to solve problems with technology If you don't share those successes with the Oklahoma Panhandle Hospitals or the, you know, the Montana hospitals.
Speaker 3:Like those, people suffer from the same problems and it's a shame that they don't have the opportunity to learn from the stories that happen in the big cities, and I think that that's something that healthcare can really think about and learn from, and not put it all on the Agency for Healthcare Research and quality to put out a white paper that maybe everybody will get around to. So that's why we make documentaries, that's why this film exists. We're trying to add a new way of sharing information, showing what it looks like when people in healthcare do the work, and I think people resonate with film in a way that's very different than they do with a white paper or a lecture. I know they do and I hope that people will see the film and will be able to share what they saw and maybe talk about how to adapt those ideas to their own institutions or their own hospitals. That's what this can do and why I'm appreciative of any opportunity to talk about it to reach a new audience, like yours, for example.
Speaker 2:What do you envision for the future of patient safety?
Speaker 3:Well, I do think more problems are being solved every day. And look to answer the question briefly, to go back when we made the first film. That was right around when the new Johns Hopkins study of 250,000 a year dying came out and kind of on the heels of the John James study, that 400,000 people a year were dying, and people were always like, well, you know, the numbers are so much worse now than they were in 1998. How is that possible? They probably aren't any worse and it doesn't matter which number you pick, it's always too many. But the numbers of people who are dying every year from complications or direct patient safety harms, like it's because we know what they look like more and more every day.
Speaker 3:Hospitals are better at identifying when healthcare is not going the way it's supposed to go, and the data is there to know when something is trending in that direction. So to answer your question directly, I'm going to give you an analogy, right so? Or a metaphor, whatever, I forget which it is. Um, this is actually how I wanted our film to end when I first wrote the outline. We didn't have the, we just couldn't pull it off. So the beginning of our movie, the first two minutes, is like, strictly a scene, a baseball scene. We filmed the scene where, you know, we put the analogy in front of you about how errors in baseball are. You know, a parallel to errors in medicine. But when somebody makes an error in baseball it causes a run to score. In healthcare it can cause someone to die. Right Easy metaphor to understand. Right Easy metaphor to understand.
Speaker 3:Now, if you go a little bit more nerd baseball nerd on you, if you know anything about the last few years of baseball in the money ball era kind of started this and publicized it a little bit more. There's so much data about what happens on a baseball field at any given pitch that they got so good at predicting where a hitter was going to hit the ball. They would put everybody on the infield to one side because they knew historically, looking at the data, that this specific hitter will more than likely hit the ball to that side of the field against this specific pitcher and most of the time they were right and they were so good at it that they banned it in the last couple of years. You're not even allowed to do it anymore. It's called the shift and it's banned.
Speaker 3:The reason I bring this up is because this is what a future of healthcare could look like, where there's so much data and so much understanding of when this is going to lead to this is going to lead to, this is going to lead to harm that once you see that first thing happening, you can put the people in the right positions to make sure that it never reaches the level of causing harm. And in a way, that's the shift that we see in baseball, and they wouldn't ban that if it happened in a hospital. So that's the future I want to see. I want to see where the data that we're so good at collecting and not really doing much with it just sits there is turned into actionable items that people know what to do with. I think the command center is a great example of that. In the biggest possible format, we can minimize the command center idea so that every hospital has a chance to operate with that much of efficiency and using the data in the right way.
Speaker 2:Oh, that is really cool. I can see the shift working in anesthesia care as well, because they're doing a lot more machine learning with patients' blood pressure. Because we know that low blood pressure during surgery and anesthesia is associated with increased risk for morbidity, mortality and postoperative complications, and so they're using some algorithms and there's some programs out there that you can intervene before a patient's blood pressure dips below a certain threshold, and so it's similar to that idea where then we can put the shift, as anesthesia professionals can kind of put the shift on to prevent that low blood pressure which then down the road helps to prevent the complications.
Speaker 3:I mean, that's exactly it, and look, a lot of the conversations around technology and medicine and technology in any way is the fear of AI and replacing doctors or replacing humans, and in some industries, yeah, it's just the way it's going to be, but in healthcare I don't think it's ever going to be like that. I don't think we're ever going to see a future in which we don't have human beings delivering care and, frankly, if you see a hospital that has no human beings, don't go do it experience. And it would be great if a lot of the work that makes it hard for clinicians to enjoy their job but also to be good at it was left to computers. That's what the computers are good at Deciphering information and giving the clinician the ability to make an informed choice. When you give the clinician the ability to make an informed choice, when you give the clinician the ability to make an informed choice, they're probably less likely to make a diagnostic error, which is a huge part of patient safety.
Speaker 3:The successful ideas that I've seen so far since starting production are usually the ones that assist the clinicians in doing the work that they really can't do efficiently. For the most part, I think the care of a patient can't be replaced by any sort of robot, and I know that post-COVID, with telemedicine, they're trying these things out. They're trying out diagnosis being delivered by AI bots. No chance that that's good for anybody. It just can't be good for anybody. And maybe it streamlines the process a little bit. But this is healthcare we're talking about. We don't need to rush. That's the thing that's so frustrating. That that's where the problems began over the last couple decades is this desire to speed the process up. No-transcript.
Speaker 2:What is next for your projects? Do you have any other patient safety projects in the pipeline?
Speaker 3:I think I'm never going to be done with patient safety at this point. I've been doing it for 10 years now, almost 10 years, and with my father, you know, really sort of still being at the tip of the tongue for a lot of people that I've met along the way who are still inspired by his work, and that means a lot to me. I want to make sure that we continue to do this work, and maybe that's documentaries, maybe it's some other form of playing a role in all of this, but I have found myself just very invigorated by this world of patient safety. I think people really want to see things move in the right direction and there are so many stories. At the end of the day, if you really want to make a difference in something like this, you have to tell the stories of patients who've experienced harm, of the people doing work behind the scenes, all these things that just don't really get in the headlines, because why would a newspaper tell that story? They want to show you the horrible stuff and I really want to make sure that a positive voice is out there sharing the other side.
Speaker 3:Maybe, like I said earlier, maybe there's a burnout documentary that's no-transcript, splits it up between dog walks or whatever. But if we really want to make a difference with films like this specifically, we've got to get it in the hands of the people who are the changemakers in healthcare, and I don't mean just the CEOs, I mean the clinicians, the doctors, the surgeons, the nurses, the admins and the patients people who are really activated and want to make sure that their hospitals are doing the best they can. So there's a lot of work to do in that regard and as long as we don't have another pandemic, we should be able to keep going. So we'll cross our fingers on that, but there's always going to be work to do and we'll do our best to stay at the tip of it there's always going to be work to do and we'll do our best to stay at the tip of it.
Speaker 2:Well, and I like how you mentioned so many different people who do need to be involved to make these changes happen, because I think one of the focuses of the APSF is that it is multidisciplinary. Even with our focus on anesthesia, patient safety, we know that that involves the entire perioperative space and then also incorporating technology and nursing surgeons. You know this a very wide spectrum to really enact change.
Speaker 3:Yeah, they usually ask who's your audience when you're first making a documentary and probably for a podcast, probably for any mixed media at all. But I hate that question because everybody needs to know these things. The problem is it's how you deliver that. Information isn't the same for everybody, and so when you're writing a white paper, you're specifically talking to the clinical audience. When you're doing a lecture, you're probably specifically talking to an educational audience. When you're showing stats and numbers and writing headlines, you're probably talking to the general public and the patient sort of community.
Speaker 3:Documentaries do have the power of doing all of that at once and and that's why I love this genre I do probably need to take a little bit of a break from healthcare documentary filmmaking.
Speaker 3:It's a very heavy topic, but but I'm never going to, I'm not done.
Speaker 3:But I maybe I need to make a documentary about, like conch shells or something.
Speaker 3:Uh, it just needs to like switch it up for a minute, but I'm coming right back, I'm sure, and at the end of the day, the hard part is is these things cost a lot of money and you really need support, financial support, to make a documentary. They don't really happen out of your back pocket and if it takes me a while to get there, then maybe there are other formats, other mediums that I can explore to continue to tell these stories, and I will do that. But for now we got a nice film to promote and to make sure people get to see, and Patient Safety Awareness Week will be in March and we'll hopefully have another second, a second wind, uh, you know this film released on world patient safety day and, and that's September 17th. Uh, patient safety awareness week is a whole week of possibilities. So I think having March and September really gives us a bookends on the year to really kind of make sure people are focusing on this, um, when they're already sort of engaged in patient safety conversations.
Speaker 2:In New Zealand right now. It is Wednesday, the 16th of October, and so it's World Anesthesia Day today, so it's just kind of cool that we're recording on that day.
Speaker 3:That's great and it is important to have these days, because these are not topics that get their own time in the light every day, and especially right now with American politics that runs the media cycle. So they're not talking about patient safety. That's not something you campaign on. But yet, at the same time, you know, just just a couple of weeks ago or a month ago, the Biden administration continued the progress that's been ongoing with groups that are collectively trying to help form a patient safety version of what aviation has with the what's it called. I might have to plug that in, but, but uh.
Speaker 3:But the bond administration has continued the work and initiatives to make sure that patient safety is an effort that's funded at all levels and has organized focus, can actually have people focused on what's happening in healthcare so that these innovations that do come along can solve the right problems. So I hope that that continues. I think it's a literal coin flip of whether that will continue or not, depending on what happens here. But I think it's a literal coin flip of whether that will continue or not, depending on what happens here. But I think patient safety is always going to be a very important priority for people and we just have to get the word out. We have to make sure people know that.
Speaker 2:Absolutely. That's why, when we expanded to the podcast realm from the APSF newsletter, we were hoping to reach more people, and it's the idea of just trying to reach as many people as possible to say this is what's happening in anesthesia, patient safety, and then try to reach a wider audience and then different forms of media too, whether it's like short we do short films, we have podcasts, we have newsletter articles. So we're trying everything to help improve safety and that's great and that's what we need.
Speaker 3:Uh, it's just not going to happen if we wait and sit back. It's it's sort of like climate change, you know. I think everybody knows it exists, but most people feel like it's too big of a problem for them to solve in their own individual way. But that's not true. It's just you don't. You might not see the impact you're making. And the same thing goes for patient safety.
Speaker 3:Every single person who enters a hospital as a patient can play a role in making sure that the care they receive is safe and delivered in the right way. They just have to be an active part of their experience. They can't just sit back and wait for things to happen to them, and the clinicians are really the people who will dictate what is prioritized in a hospital in terms of the way the staff is built and the way the organization is built from the ground up. Just have to open up and have to speak up and have to say this is important to me, what are you doing to make it important to you? What are you going to do to make sure that the tools that I see another hospital doing in this documentary are coming to this hospital? So that's hopefully how we can make a difference.
Speaker 2:Yeah, that is a great question for people to ask. One thing I wanted to end with. I just like to ask is there anything that we did not cover today that you wanted to talk about?
Speaker 3:The important thing to me is people understand the importance of the conversation. Our film is 60 minutes long. It's not that long. It's an hour out of your life but you know, not everybody has an hour to spare all the time. I hope people get a chance to watch the film, but where it really thrives is when we have a panel conversation afterwards and you know if we can get screenings put together. I think that's really where we can see the impact directly.
Speaker 3:I want to get those screenings happening. I we had, I think, 12 in September and we have almost as many in October and I want to keep that going. So it's not really a topic we didn't discuss. It's sort of just a if you're still with me, help me out. Let's call your hospital, try and find out somebody who's in charge of patient safety organization at the hospital, or if you work at a hospital, you know, go to the website. It's wwwthepitchdocumentarycom and we have a form on there that people can fill out to just get connected with me to help organize the screening, and it'll be with me directly, like I will work with you to make it happen. So I love that part of the job. That's my favorite part of filmmaking. I like filmmaking, like I like making the movie. It's nice, what I really like doing is sharing these films.
Speaker 2:Thank you so much to Eisenberg for joining me on the show for these past two weeks. We are looking forward to the future, with increased use of technology to improve patient safety. We will be back next week with an all-new show focused on the October 2024 APSF newsletter. If you haven't done so already, we hope that you will make plans to see the pitch and check out the October 2024 APSF newsletter. There are so many great articles. If you have any questions or comments from today's show, please email us at podcast at APSForg. Please keep in mind that the information in this show is provided for informational purposes only and does not constitute medical or legal advice, medical or legal advice. We hope that you will visit apsforg for detailed information and check out the show notes for links to all the topics we discussed today. Until next time, stay vigilant so that no one shall be harmed by anesthesia care. Thank you.