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Joint Commission quality guru: Beware the Darth Vaders of healthcare

Remember the famous scene in the original “Star Wars” movie (“Episode IV: A New Hope”) when Darth Vader choked an underling who questioned his authority? That happens all the time in hospitals, attendees of the Cleveland Clinic’s Patient Experience: Empathy + Innovation Summit heard Tuesday.

Remember the famous scene in the original “Star Wars” movie (“Episode IV: A New Hope”) when Darth Vader choked an underling who questioned his authority? That happens all the time in hospitals, attendees of the Cleveland Clinic’s Patient Experience: Empathy + Innovation Summit heard Tuesday.

“You all have Darth Vaders,” said Dr. Ronald Wyatt, medical director for healthcare improvement at the Joint Commission. “You know who they are. They create a toxic environment in your organization. And you know what happens? Some people can’t breathe.”

Healthcare executives and supervisors must be capable of listening to their charges and allow criticism because a “culture of silence” is toxic and potentially deadly, according to Wyatt. “Without a culture of safety, there is little trust and very little improvement,” he explained.

“If you can’t breathe, what happens? Oxygen can’t get to your brain,” Wyatt said. Mistakes happen. Morale suffers. Nurses leave. Patients get hurt. “Leaders have to understand that if you can’t address that now, [you should] step aside right now.”

Joint Commission research has revealed that 82 percent of nurses see incompetence on a daily basis and that 84 percent regularly see workarounds and shortcuts, Wyatt said. Often, they are too scared to speak up. “An inaction in culture is a violent act,” he said.

“When we ignore the signals, we fail. We fail our staff, our patients. In truth, we fail our community.”

Wyatt related the story of when he went in for retinal surgery, but was unable to stop blinking enough for the surgeon to complete the procedure. It was not until learning that Wyatt was, at the time, director of the Military Health System’s Patient Safety Analysis Center — now the Department of Defense Patient Safety Program — that the surgeon suggested eyelid lifters.

Wyatt was flabbergasted that the surgeon only seemed to care about people who seemed important. “My name is Ron. The people who know me best in Perry County, Ala., call me Bubba. I have a wife. I have kids. That’s who I am,” Wyatt recalled telling him.

This physician apparently had forgotten the Hippocratic Oath.

“First, do no harm,” Wyatt said Tuesday. “Love your patients. Love your staff. Love each other. Love your community. There is no quality without love. There is no empathy without love,” he advised.

After all, even Darth Vader eventually felt love and empathy for his son as he was dying at the end of “Return of the Jedi.”

Photo:  20th Century-Fox/Getty Images