Medical Director Los Angeles County Fire Department Rolling Hills Estates, California
Disclosure(s):
Clayton Kazan, MD, MS, FACEP, FAEMS: No financial relationships to disclose
Every day in our organizations, as call volumes rise and pressures mount, our personnel make small trade-offs and decisions in order to get their job done. As they do so, the margin of safety created in the system is slowly eroded towards failure. Failure only becomes available in hindsight from those of us who analyze the wreckage and know the outcome. To our personnel going on call after call, drift is invisible. It is too gradual and consists of the messy side of getting work done. Small incidents do not precede major ones, normal work does. So, how do we redesign our system in a way that it can remain adaptive and resilient while maintaining margins of safety? By following the examples from high reliability industries like aviation.
Learning Objectives:
Upon completion, participants will be able to explain the concepts of normalization of deviance and margin of safety in complex EMS systems
Upon completion, participants will be able to demonstrate understanding of the paradox between policy/regulation and the ability to successfully navigate complex work environments like EMS
Upon completion, participants will be able to understand the constraints of economic pressure, increasing workload, and the need to practice safely. EMS operations exists in the boundary of these factors.
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