The complexity of medicine has been acknowledged as one of the contributing factors of healthcare-acquired infections (HAIs), in that a greater use of medical devices and interventions invariably results in potential complications and infections. It is the acceptance of these adverse patient outcomes that consternates patient safety experts who are endeavoring to change the mindset of clinicians while using simple tools and strategies proved to fight HAIs.
A wry illustration in an issue of The New Yorker captured the essence of that bastion of complexity in hospitals, the intensive care unit (ICU) – it accurately portrays and skewers the tremendous tangle of wires and hoses that snake back to dozens of machines that lend life to the sickest and most vulnerable of patients. Gawande (2007) describes the chaos: “Machines break down; a team can’t get moving fast enough; a simple step is forgotten. Such cases don’t get written up in The Annals of Thoracic Surgery, but they are the norm. Intensive-care medicine has become the art of managing extreme complexity—and a test of whether such complexity can, in fact, be humanly mastered.”