The frame of error #WILTW

This is the 186th #WILTW

This is an extension of a post I wrote over 2 years ago describing my experience of airport security.

The delay, even with an express security pass, was considerable and I must admit I was getting increasingly nervous even before my bag was picked out as having a problem. The delays were not due to volume of people but the absence of any haste from the staff. There was absolutely no urgency at all. It was painstaking to watch. You could see people becoming increasingly frustrated as the pre-scan person would carefully manoeuvre items around the boxes before pushing them through the machine. The person reading the x-rays would move backwards and forwards on each and every item. The man handling those flagged as ‘at risk’ would ponderously remove each and every item from the bags he was reviewing. It was painful to experience with the frustration clearly exacerbated by being in a rush.

Emergency departments also have to process lots of people but equally need to make sure each person has a thorough, and timely, assessment as they may suffer harm if they aren’t ‘processed’ quickly enough. Gavin Lavery who was giving me from the airport to the conference venue raised an interesting point about how in healthcare, in order to meet an ever increasing demand, the staff just ‘find a way’. Either going beyond capacity to find beds, or being able to review more patients in less time, during peak periods. The benefits of this are obvious but it creates a paradigm where you don’t follow the ‘manual’ at all times. Arguments regarding the use of checklists persist because staff want flexibility in the way they work. Sometimes because they are stubborn and don’t wish to change, but sometimes because they know they do need to change they way work in certain circumstances. A challenge in healthcare is maintaining safety during these flexible periods of working.

I wouldn’t be able to work a security officer in an airport. I am not sure I would be able to maintain the air of someone whose desire for safety completely overrides any patient experience, day in-day out, regardless of queues and the relentless stares of the public. But perhaps on a busy shift I’ll remember that just working that bit harder, or cutting that small corner, isn’t really what a ‘safe’ system should do.

I had completely the opposite experience this weekend. A surprisingly deserted security area for an international airport with staff looking around for something to do. It was a pleasure to be able to pack my hand luggage and coat into the grey boxes without the stress of losing anything or feeling you have a 1000 eyes bearing down on you because it’s taking more than a millisecond to unpack your pockets.

It was only when I went though the metal detector I realised I’d packed a couple of items above the 100ml limit in my bags. I felt frustrated to likely to be losing some aftershave that had been brought for me as a present.

But it wasn’t noticed. My bags came through the machine without being pulled aside and I was allowed on my way. I am not entirely sure of why there is a 100ml cut off but I am sure that what I’d brought was more than 100mls. What is the point of advertising a security standard that you aren’t going to uphold? Especially when you are rigid about the reproducibility of your approach regardless of how busy you are.

Conversely mistakes happen in all walks of life. Our tolerance of them dependant on the impact they directly have on us. Why should I be frustrated at a minor slip up at an airport but able to explain away minor deviation at my own place of work? The frame of the impact of error an important determinant of your reaction and response to it.

What have you learnt this week? #WILTW

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