eHealthRisk Blog reader Kim Sanders-Fisher posted a lengthy comment on my previous post Dealing with Whistleblowers concerning her own personal experience as a whistleblower at a prestigious US hospital. Her comment suggests that my assertion, that every health care organization should put a reporting system in place that allows staff to report safety, privacy and other risk issues without fear of retribution, was somewhat simplistic.
In a perfect world we would encourage and thank people who report matters that compromise the safety and wellbeing of patients and health care workers. In reality, the world is much more complex and, often times, nasty. We continue to live in a blame-oriented culture that would much prefer to kill the messengers (i.e. whistleblowers) than to accept that our organizations and the people who run them are less than perfect.
Unfortunately, even whistleblowing programs and protections that are in place in progressive organizations are easily subverted by low, middle and senior managers who have a vested interest in maintaining the status quo, even if the status quo poses risks to patients and others. Its too easy to blackball someone, making their life miserable, in the hope that they will just go away.
Quis custodiet ipsos custodes? (Who guards the guardians?) Its sad that those in positions of authority in many organizations will tend to act in their own self-interest and the interests of the organization, rather than in the interests of patients.
I am coming to the conclusion that we must implement independent mechanisms such as the Aviation Safety Reporting System to address risk issues in health care, including safety, privacy and security issues associated with eHealth such as security deficiencies, software and other technology errors and poor human factors engineering. This would include the many systemic and organizational issues that will arise as health care providers us eHealth tools to deliver health care.
I'm waiting to hear about a positive whistleblower experience. One where the whistleblower was acknowledged and thanked for taking a personal risk to protect the interests of the patients they were caring for.
I'm not holding my breath.