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Jul 13

Holy HRO: High Reliability Organizations (Part 3)

We will continue to post blogs and media-casts on high reliability organizing, but until then we added a few pdf’s for your viewing and downloading pleasure below.  Started on a rant last night for this page.  It involved Death Wish Coffee and a playlist of Rage Against the Machine & Five Finger Death Punch.  What was produced was a visceral attitude - highly irritated rant on what it would look like if the current studies published (on topics like junctional tourniquets) by “big name” docs who also reside on military committees approached their endeavors as an HRO.  

The result would potentially be good for the whole community.  This would potentially be in stark contrast to conducting the same laboratory study (in a non operational context) repeatedly.  This repetitive approach is potentially done in hopes of gathering enough “meta-analysis” or RCT’s to improve the epistemological strength of their decision to make it into an “evidence-based” guideline.  I opted not to post it.  Maybe in the future we will, after the next article or guidelines are published, recommending another specific junctional tourniquet for end-users that breaks every time I perform a rescue (because I have to bend casualties where the device articulates with the human body).  I am sure there are rescues out there...some where, in an alternate universe, that only occur in the laboratory.  Why would we ever think about evaluating it within the system of casualty management (real-world application) before placing it in guidelines?  Especially if those guidelines are attached to a Casualty Evacuation Program that consists of high angle, confined space, structural collapse, and vehicle extrication.  (Please appreciate sarcasm of last paragraph)

So, as a tribute to “meta-analysis” and “RCT’s”, celebrating this evidence-based medicine (EBM) methodology (and sometimes lack of ...remember the CRoC?), we include the first article below.  A must-read for all, showing the brilliance of trying to make the square peg fit into the circle, putting one’s faith in a single methodology...EBM.


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