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Posted by Ishani Ganguli November 8, 2011 07:00 AM
Thursday’s The Office hit close to home. In the episode, Dunder Mifflin CEO Robert California descends upon the Scranton branch and demands that regional manager Andy Bernard put an end to the staff’s sloppy errors. Dwight has a solution, carefully guarded in an accordion file: The Accountability Booster, an electronic device that registers mistakes - from late deliveries to accounting blunders. Five such strikes in a day is a home run, one home run and you’re out, Dwight explains with his trademark disregard for logic. The penalty for a strike-out is an automatic leak of incriminating emails to the boss and near-inevitable branch shutdown.
Throughout the day, the red Xs accumulate as the social experiment unfolds: The accountants question Oscar’s mental math and distract Kevin, the weakest link, with a made-up assignment. The staff huddles around Jim as he attempts to hack into Dwight’s system and defuse the Doomsday device. When the error count hits five, chaos ensues and all hands are on deck to convince Dwight to stop his device and distract Mr. California from its potential consequences.
IMHO, this comedy of errors bears analogy to our relatively nascent patient safety movement.
To be fair, the paper business is a bit more predictable than medicine, but Dwight has us beat on error detection with his handy all-in-one system. Dwight declares that they are now working in an environment of accountability. Good thought - patient safety researchers have shown that culture change is key to success. But such a shift requires buy-in from all involved (the Scranton team goes in kicking and screaming) and can’t be built in a day.
And though Dwight believes that “without a safety net, people will improve,” fear is hardly an effective motivator for reducing errors: instead of deconstructing the root causes of their errors and seeking ways to prevent future ones, Jim and crew spend their time and energy trying to find an easy way out. It doesn't help that they have no guidance from the leadership to make these changes. At the end of the episode (spoiler alert!), Dwight decides to take pity on the staff and deactivate his device, but the employees are no wiser than when they began.
We are doing a little better on the health care front. We are starting to learn from our mistakes and finding the right balance between systems and individual responsibility. We have found that even if “pobody’s nerfect,” we have a lot of room to grow.
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About the authorIshani Ganguli, MD, is a journalist and a second-year resident physician in internal medicine/primary care at Massachusetts General Hospital. She studied biochemistry and Spanish at Harvard College and received her More »
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