Future Healthcare

How crises cause brain block

Our trio of writers – two doctors and an airline pilot – are co-founders of a business on a mission to improve patient outcomes by helping healthcare professionals understand why errors occur. 

Analysis of a number of high-profile medical errors has demonstrated poor crisis management. In their fourth and last article in the series, John Reynard, Tim Kane and Peter Stevenson discuss the Elaine Bromiley case as a classic example of poor crisis management, and analyse it according to High Reliability Organisation (HRO) principles, focusing especially on our psychological response to a crisis.

An analysis of a large number of aviation disasters revealed that crises were not infrequently managed badly, even by highly experienced air crew.

The aviation industry realised that a systematic approach to crisis management had to be developed which involved training before the event and developing systems of managing a crisis in a better way once one had unfolded. 

Aviation has led the way in practising common crises in a simulator – an environment where pilots can test their response to a crisis and then, critically, can practise in safety to get better at handling it.

The ergonomics – people’s efficiency in their working environment – of crisis management have been addressed by a number of industries. 

Everyone will have experienced the unpleasant sensation caused by the surge of adrenaline rush, which, in turn, causes a rise in pulse and blood pressure. Less well known and understood is the cognitive response to a crisis, a response which can impair effective management of what is happening.