I've been thinking . . . about Seattle, New York, Indianapolis, and Madison.

I spent the to-be-forgotten Father's Day of '95 on the front row—just past the dugout on the third-base line—at a Seattle Mariners' baseball game. Turned out to be the opportunity of a lifetime. Three balls were fouled my way.

I dropped the first and took the heat—from my five kids, no less. This hardly boosted my confidence for the next grounder, which I also dropped. While one understanding dad offered me his glove, “Here buddy, just in case,” other nearby fans ragged on me. You guessed it—I bobbled the third. The entire merciless crowd booed when the scoreboard flashed, “FAN ERROR.”

Baseball is played in a punitive culture. In addition to boos, the ballpark scoreboard records errors, not just hits and runs. Statistic books etch in stone the number of E's each major leaguer makes in his career. And if you were not at a game to witness an error, no problem, it will be replayed on Sports Center in the evening. Should you miss it on Sports Center, not to worry, there may be another chance to pick it up on a bloopers video between innings at a ballpark near you.

However, when a player who bobbles a ball leaves the field, he generally returns to a nonpunitive dugout full of teammates who slap him on the butt and say, “Nice try.”

In healthcare, even more than in baseball, no team member wants to commit an error. At the same time, no caregiver relishes having others know about it when they do. Nevertheless, we have come to understand that medication errors must be reported and analyzed so we can discern how things go wrong and fix the system to prevent repetition. We have also learned that the most thorough reporting practices develop in a nonpunitive culture. Thank God that hospital dugouts are increasingly places of support rather than punishment.

However, the crowd outside the hospital is another story. The media picks up on errors and endlessly regales the nurses and chides the hospitals, the way the Yankees booed A-Rod and the guys in pinstripes when they failed to advance in the World Series this year. The only difference is, that when these same nurses and hospitals do the right thing day in and day out, preventing errors and promoting healing, few are watching and fewer cheer as they do when A-Rod turns a double play or pokes a triple in the gap.

Sometimes I feel like a lonely Mariner fan in Yankee Stadium, as if I'm the only one out there cheering for our healthcare providers. But I don't give a rip. I'm giving a shout out for the excellent care that patients receive from disciplined and dedicated nurses and pharmacists at the Methodist in Indianapolis and St. Mary's in Madison. They'll never bat a thousand—they are human, after all. But for all the good they do, day in and day out from their positions on the field, they deserve and ought to receive our applause. God forgive us for damning these dear people with faint praise.

What do you think?
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Mark Neuenschwander
mark@hospitalrx.com

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