Dr Michael Buist is an intensive care specialist with a unique perspective from both sides of the hospital curtain, having himself almost died twice due to medical mishaps.
As a medical registrar he survived a lung tumour that went undiagnosed despite an X-ray. In 2008 a routine operation for appendicitis left him on the brink of death. A last-minute diagnosis from his obstetrician brother probably saved his life. Galvanised by these experiences, Dr Buist is now on a mission to reduce the number of unnecessary deaths in hospitals worldwide.
He freely admits that healthcare can be a dangerous business. Ten per cent of people entering hospital can expect to suffer an adverse event and of those, another ten per cent will die or experience a serious disability. As living proof of those statistics, he’s emerged as a world leader in the push to improve patient care with a range of thought provoking ideas to reduce human error inside hospitals.
At Dandenong Hospital in Melbourne, Australia, a middle-aged male patient unexpectedly took a turn for the worse. Faithful to standard procedure, the attending nurse read the patient’s vitals and called the on-duty junior doctor, who made appropriate medical interventions. Although the patient’s vitals and readings technically would have promoted the case to crisis level–requiring specialist doctor intervention – the patient seemed to stabilise. Both the nurse and attending physician felt assured that the patient would recover soon and agreed to an additional check the next morning. However, less than 45 minutes later, the patient’s health destabilised again and, despite their best attempts, the patient was lost moments later.
In the subsequent legal trial, the nurses and doctors involved in the tragedy were cross-examined and questioned as to why they made the decisions they did. The central question at play was: ‘Why did no one simply call the crisis medical team?’
This was the relevant standard of care and policy of the hospital. One of the crisis specialist doctors on call was Dr Michael Buist, who testified that he was on call that day and would have readily responded if only he had been notified that the patient had reached crisis levels. But the call never came.
In the aftermath of the trial, this tragic story haunted Dr Buist, and he soon dedicated himself to ensuring that mistakes like these would never happen again. He had spent years in the healthcare industry and knew that its corporate culture was laden with layers of procedures that required attending nurses and physicians to go through multiple approvals and calls in order to move patients to appropriate care.
Often, these layers delayed urgently needed attention and were subject to the discretion of busy medical professionals on the ground. Many nurses and doctors dreaded the thought of having to hunt down higher-level doctors on call, and this part of the established culture added to the difficulties in cases like these.
The surprising solution that Dr Buist discovered came from the world of IT.
With his team, he developed software that tracks patients’vitals and other relevant data from the hospital bed, and immediately notifies the appropriate doctors on call to intervene when certain thresholds are reached.
Sounds simple, right? But, as professionals in every field know, a simple solution to a problem is not always welcome when it involves changing a deeply ingrained culture. Dr Buist eventually found a hospital in the United Kingdom is willing to partner with him. The application ignored and bypassed cultural issues that were putting patients’ lives at risk – the results were astounding.
The trial showed doctors’ performance improved from 66% to 98%, with a huge reduction in mortalities. From the custom user interface of the application (designed with feedback from nurses) to the ease of escalating patients to the appropriate specialist doctor, hospital staff embraced the use of the new application.
The number of hospitals using Dr Buist’s application continues to grow – the future is much brighter for the healthcare industry, and most importantly, for patient care.