What is evidence? How do we gather evidence of patient harm? More importantly, what is the evidence that counts?
A research paper dating back to 2004 suggests that besides research evidence, clinical and patient experiences, as well as contextual information also constitute evidence. However, the only currency of science is data collected through systematic and rigorous research.
But when it comes to the business of medical error, the 3rd leading cause of death in the United States…research is a vehicle that doesn’t get us far enough. It lets us look through a straw at “wicked problems” – a term coined by Rittel and Webber to describe problems so complex and multi-faceted that science can’t sufficiently address them. Policy, economics, climate change, and even some types of software design have all been dubbed wicked problems. Medical error has undoubtedly joined the ranks.
Research only allows us to sample brief instances in the patient care continuum. And because medical error is often a consequence of multiple little things that go wrong adding up to potential harm, sampling can’t capture all of them. What is needed is continuity across the care continuum. Only the patient or their caregiver have this continuity. This is where stories come in.
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