Monday, August 1, 2011

Trouble With Transitions Anyone?

I am always looking for new intellectual and physical challenges, which is why I entered my first-ever mini-triathlon last year. After having done two, I am about to enter another race this weekend in my hometown to see whether I can improve my ranking this time. I find that the hardest part is not any one of the three legs, i.e. swimming, biking or running, but rather the transitions. Biking at my maximum performance for about an hour seems to program my body in such a way that changing to running becomes almost impossible, at least for the first mile or so. It is difficult to move my legs in front of each other. 

Intellectual transitioning is also hard to do, but often a requirement. Professions where these transitions may involve life threatening or emergency situations typically require a lot of training. Examples of that are pilots who suddenly need to react when an engine fails or other serious condition occurs. 

Healthcare IT or PACS system administrators face similar requirements to be ready for stressful transitions. You might be in the middle of upgrading a device, when you get a call to update the demographics of a procedure because a technologist entered the information incorrectly. 

Some of the tasks you are performing require a lot of concentration because of the potential impact if you make an error. Imagine the impact if you made an error while making a backup, and that backup was needed because the original information was lost due to a major disk malfunction. If you make a mistake updating a study, it could result in the information or image being assigned to the wrong patient. 

Unfortunately, humans make mistakes, especially if they are in a multi-tasking environment and have to transition often from one domain and/or activity to another. I would argue that most errors can be attributed to human error, rather than hardware failure. One local hospital told me that their last significant PACS downtime was due to a service engineer from the vendor who remotely used an incorrect database backup, which corrupted the original, causing a 4-hour PACS downtime. Needless to say, it pays to monitor anything that happens with the system, even if it is done by your vendor. 

In conclusion, be aware of "transitions" and focus on the activity at hand, especially if you are dealing with issues that will impact the lives of others in a potentially significant manner. 

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