Guarantee your Safe Care from your Doctor, Don’t Become a Medical Error Victim [Interview][Transcript]

Stephen_Powell_Avoid_Medical_ErrorsGuest: Stephen Powell
Presenter: Neal Howard
Guest Bio: Stephen Powell, MS, is the chief executive officer and president of Synensis, a healthcare consulting firm dedicated to helping hospitals achieve zero preventable harm. He is a recognized leader in the development of practices, behaviors, and strategies to improve organizational outcomes and is a member of the development team that created the TeamSTEPPS teamwork and communication system for healthcare organizations. Powell has supported the success of More than 350 organizations in 11 countries to improve patient safety, quality, and the patient experience by creating a culture of safety. He earned a Master’s in Human Factors from Embry-Riddle Aeronautical University and is a graduate of the Naval Postgraduate safety school. He is a member of the American College of Healthcare Executives and the Clinical Human Factors Group.

Segment overview: Stephen Powell, coauthor of The Patient Survival Handbook and CEO of Synensis, a healthcare consulting firm, discusses how patients and families can maximize their safety while under the care of a doctor.


Health Professional Radio

Neal Howard: Hello and welcome to Health Professional Radio. I’m your host Neal Howard, thank you so much for joining us today. In studio today with us is returning guest Mr. Stephen Powell, the CEO and President of Synensis also the co-author of “The Patient Survival Handbook.” And he’s been involved in human factors education and team work training in the United States Navy, the commercial airline industry and a healthcare industry for over 25 years. He has also helped create the TeamSTEPPS strategies and tools to enhance performance and patient safety as a team work improvement system and is based on over 25 years of research and evidence on team performance. And he is here today to talk with us about his company Synensis and his book ‘The Patient Survival Handbook’ and to give us some specific tips on how to keep ourselves safe when were under the care of a doctor, when were hospitalized and even after we go home. How are you doing today Stephen?

Stephen Powell: I’m doing great Neal. Thanks for having me on your show.

N: Thank you so much. As the co-author of The Patient Survival Handbook, obviously you’re an advocate for zero preventable errors occurring during hospital stays, even after a patient goes home. We were talking briefly in another segment when you were here with us before about some of the questions that a person should ask to help prevent errors, and to make sure that everyone is communicating and on the same page as it were when it comes to your particular medical case. When we’re talking about doctors, and surgeons, and specialists, sometimes it can be pretty intimidating to ask those questions when we kind of went into it thinking that “Well they know what they’re doing.”

S: Yeah, exactly. And I think where that really runs in were I see that more so Neal is when I’m dealing my mother she’s approaching 80 now and she comes a little bit more from a generation where you’d really didn’t question those people in authority places, and it was kind of rude in a way. And so they did, there was a tremendous trust that we place within our healthcare professionals and it warranted, they go to regular setting patient and they spent years of time understanding how to best treat us and how to care for us. So it’s warranted but the side of that where the reason that we would race some of these questions really is to decide that it’s not always that we haven’t talked through when it comes to being safe in our healthcare and in our hospital setting or even our extended care or any other setting that we find ourselves proceeding health, an outpatient lab setting or what not, which is this idea that even our doctors and our nurses as highly trained they are, they’re humans and they make mistakes.

N: Uh huh.

S: They make mistakes just like you and I do each and every day. And so the questions that we’re really asking them are not only helpful to us but they’re also helpful to those healthcare professionals. And so what we found in the book was that health professionals are really keen to answers your questions. The one thing I would say about asking questions is to prepare your questions ahead of time if that’s all possible. And there is a great school what we call questions that we would say “Ask me three.” And those questions are again, what is going on with me? What do you believe is happening to me? I need to know what you know. And I need to know it in a way that I can understand it. And then why do they think this is happening to me? And that’s really important and then again, what it is that we’re going to do to make this situation better? And these are easy questions to ask to begin in our conversation with our healthcare professional. So these are the beginning dialogues and I believe that there are ways other questions, I love this question we learned in our process of the question of asking a healthcare provider. Once you’ve been given what you believe to be your diagnosis or what they believe is going on with your health condition and the reason that you come in or what they believe is happening or what they’re going to set you up for course of treatment is. That in that simple question of your busy healthcare professional, “Could it be anything else?” That’s a great question because that “could be anything else question” is a way for your healthcare professional to actually go through another thinking, what we would call a situation awareness loop that in fact now they might ask you more questions.

N: Okay.

S: And take one more, it’s almost like getting a second opinion if you will Neal just by asking that question.

N: Now how often is as physician or a healthcare specialist not giving a pertinent piece of information or a piece of information that could be questionable as to whether or not it was pertinent. How often is not giving that information to a patient deemed a medical error that results in some type of injury or a failed operation or procedure?

S: Well I think that sometimes just like all of us in communication, remember there’s there is a relationship in communication one, and this is where we’ve talked about this before, where 70% of these errors are the result of ineffective communication, poor communication. So communication really has two parts, you’re talking about the healthcare professional, the doctor as the sender, and we the patient as a receiver of that piece of information. And so there’s many things that are important in the message. I’d like to say communication is really that it’s the response you get from the message you sent, regardless of … And so what I would say around this is that the burden for a message that we’re trying to communicate to a patient if I’m the doctor is really on the sender. So it’s really important that me as a doctor that when I provide you Neal a piece of information about your health that I gave you to check that back for me, and that’s one of the tools that we created, like a read-back but it’s not a parrot. It’s like I want you Neal to explain this in your own words what I just told you what’s going on with you, what just happened.

N: This is something that should take place between myself and my doctor, as after he’s prescribed to me some medication or given me a diagnosis is to kind of go over it to make sure I understand in my own words and that he knows that I understand.

S: Absolutely. And that’s a critical key there. And that way it keeps us from thinking or assuming or making assumptions that we’re all on the same page. This gets us on the same page as far as that care, what’s gonna happen next.

N: Now having done some telemarketing in my time, it was always very crucial in training to read-back what the client had given me as far as information, as far as contact information what their order was going to be, whether shipping was free or not. It was always important to read that back to them to let them know that I had their correct spelling, that I had their correct address or their correct zip code. Is that one of the methods in your book that you tell folks to employ when they’re with their doctor, is basically regurgitating what their doctor has said to them or vice versa?

S: Absolutely. But it’s confirmation, it’s this read-back is really, really important. If a pilot gets instruction from an air traffic controller in flight and they don’t read those instructions back specifically with all the caution in there. And the person who had been listening that’s called a hear-back, so even you as the person you’re letting the customer read that back and as a patient. I also have to be really dialed in and present with that patient should be also hearing back to interpret or make any changes to the message if it’s not correct. Now surprising Neal in medical school, in nursing schools, doctors and nurses really don’t focus on that kind of training like you’re talking about in telemarketing or in a lot of other disciplines where communication over that phone is so critical to your success. Well they don’t focus as much on that, they’re really focused more on the anatomy and on the idea of understanding the disease, and the pathology. Not so much the idea of what it takes to actually be an effective communicator, that’s not actually part of the standard curricula that doctors and nurses learn during their stay. They do spend some time in this area of patient provider communication but definitely the focus of their education is on disease management for the most part.

N: Now in wrapping up this segment as the co-author of The Patient Survivor Handbook, what type of response have you received from other healthcare professionals once they’ve taken a look at your book? At some of your talks when you’re speaking to other healthcare professionals about your advocacy and your efforts to achieve zero preventable errors, what are some of the feedback you’ve gotten?

S: Well I’ve got really great feedback because number one a healthcare professional, they are so keen number one they all take this first “Do no harm.” So that thinking is they absolutely don’t come to work with the intent of causing undo harm to you. They want to heal you, they don’t want to hurt you, but they need your help. So your part of that help equation and that’s an important part that they want you to play. So what I’ve got from what I heard from healthcare professionals and also there’s many, many tips from healthcare professionals in this book. I reached out to over a hundred key healthcare professional leaders and got their advice on how they would want to engage more with their patients especially around the quality safety of their care. So they’re excited to know that the patients might be reading this text and go on to use some of these resources in the continuum of their care, so that they can get the best advice and some good tools and strategies that they can use with their healthcare professional and get this dialogue going around, safer care and reducing the opportunity for errors. And even if the error occurs which we know they will Neal, how can you as a patient, a family member really help to mitigate or manage those errors in a way where you could actually be the one that has a good catch. And we even talked about cases where that actually happened in this construct of being a better partner.

N: Uh huh.

S: But you know it really comes down to trust, and it’s about building more trust. And that’s relationship between you and your healthcare professional. Sometimes you’re seeing multiple different doctors and practitioners these days, but you have to have tools and ways, communication methods or you can develop that trust much quicker. Doctors really want to, they are embracing this more engaged patient. And I think with this book Neal, what’s happening is patients are coming in more empowered, they want to be active members of the patient safety team. So I really appreciate Neal the opportunity to get this book out there and I think it’s a win-win for both sides to building a better relationship.

N: Absolutely. And where can we get a copy of The Patient Survival Handbook and learn more about Synensis, and yourself and your partner as well?

S: Well it’s easy, just go on is one way. On that website directly and it will link you to the book and tell you more about what’s inside the book and what you can expect from the book, and some of the stories I’ve shared today and others like them on the book. But also just check out Amazon and put in The Patient survival Handbook and it will pop up, and it will I think really be a little bit a road map for safer care for patients and their families.

N: You’ve been listening to Health Professional Radio, I’m your host Neal Howard. And we’ve talking in studio today with returning guest Stephen Powell the CEO and president of Synensis. He is an international patient safety culture expert and also a recognized safety and quality leader who leverages the power of safety cultures that drive results, develop high reliability teams, accelerate quality improvement and reduce medical errors. He’s been here with us today talking about how patients and families can maximize their safety while under the care of their doctor. It’s been great having you here with us Stephen.

S: Thanks Neal. I really enjoyed being back on your show as well.

N: Thank you. Transcript and audio of this program are available at and also at and you can subscribe to our podcast on iTunes.

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