“It was a system operating for its own benefit.”
This idea has come up in both of the tragic patient cases we’ve studied and is certainly something I’ve wondered about while on the wards. It often seems like very little of the paperwork in medicine serves any real end beyond the work itself. In the case of informed consent, an originally well intentioned process has been rendered useless. It is just another form.
In designing patient safety or quality improvement interventions that will add to clinicians’ workloads, it is crucial to ensure that the benefit derived outweighs the added time commitment (which when scaled across thousands of providers can be considerable). Furthermore, a system of continual re-evaluation and analysis needs to be in place to ensure that complacency and workarounds don’t ultimately render the intervention yet another hurdle in a long road of good intentions turned road blocks.