Blaming “Human Error” Isn’t an Excuse for Wasting 500 Doses of Covid Vaccine episode artwork

EPISODE · Dec 30, 2020 · 13 MIN

Blaming “Human Error” Isn’t an Excuse for Wasting 500 Doses of Covid Vaccine

from Lean Blog Audio: Practical Lean Thinking, Psychological Safety, and Continuous Improvement · host Mark Graban

https://www.leanblog.org/audio310 During this "let's try to get people vaccinated" phase of the Covid-19 pandemic, almost every article that I've seen about the vaccine and its distribution mentions the need to not waste precious doses. There are many opportunities for error with the different vaccines. If some of them aren't stored properly at the correct temperature, the vaccine degrades and gets wasted (or worse, gets injected and gives a false promise of effectiveness). Good process design (lessons I learned as an engineer) means being proactive and thinking about what could go wrong -- and then designing the process in a way that prevents errors or mistakes. The ideal would be "error proofing" that makes it impossible to make a mistake. Or, we could make it more apparent that a mistake has been made (for example, a temperature-sensitive label on a vaccine bottle that would let you know if it's been out of the correct storage temperature too long). A countermeasure like this might prevent the mistake of using expired vaccine. But how can we prevent the storage problem (and the waste of the vaccine) to begin with? I wasn't planning on blogging over the holidays, but this article caught my attention: Wisconsin hospital tosses 500 doses of COVID-19 vaccine due to 'human error' (See the full post at the link https://www.leanblog.org/audio310)

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Blaming “Human Error” Isn’t an Excuse for Wasting 500 Doses of Covid Vaccine

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