Mindfulness in high-reliability health care: a glance into Bali international medical centre

Abstract

Medical errors are pervasive in healthcare systems globally, and they pose significant consequences in the form of first and second victims. Second victims are healthcare professionals directly affected by a medical error, who are frequently overlooked, shamed, and vilified. Mindfulness can ameliorate second victim syndrome, however reducing the amount of medical errors would be preferable in addressing this iceberg phenomenon. WHO mentioned that the prevalence of medical error far outweighs those of Highly Reliable Organisations, which operate in high hazard conditions without meaningful errors in extended periods of time. Collective mindfulness lies in the heart of HRO tenets, which can foster a highly reliable healthcare with lower incidence of medical errors and subsequently, second victims. We explored the use of mindfulness in cultivating HRO principles by conducting a bottom-up mindfulness survey targeting the staff and top-down seminars targeting the managers. Harvard Business Review online mindfulness quiz and OECD leaders’ questionnaire were used to yield tangible (patient safety booklet and visible floor signs) and intangible results (high-level of mindfulness among staff, good level of precaution among leaders, and lack of blaming culture which leads to second victims). Further actions include scaling up more rigorous mindfulness training for the entire hospital staff.