Susan Crowley RT, MEd, Moderator: Nothing to Disclose

Kathleen Kath, Moderator: Nothing to Disclose

Andrew P. Woodward MA, RT, Presenter: Educator, Siemens AG

Melissa Jackowski Ed.D, RT(R)(M), Presenter: Nothing to Disclose

1) Define Normalization of Deviance. 2) Discuss the History of Normalization of Deviance as it relates to NASA and health care in general. 3) Reflect on current practice and describe normalization of deviance as it is applied in imaging. 4) List negative consequence of normalization of deviance in imaging. 5) Explain ways that management can combat normalization of deviance in imaging.

As an imaging professional we are taught to be a patient advocate, to be technically competent and to have a patient safety mindset. Why is it then that often times we see “seasoned” imaging professionals taking shortcuts and exhibiting behaviors that don’t necessarily embody those characteristics? This lecture will explore “Normalization of Deviance” as a possible cause of this phenomenon. “Normalization of Deviance breaks the safety culture, substituting a slippery slope of tolerating more and more errors and accepting more and more risk, always in the interest of efficiency and on-time schedules.” (Prielipp, Mago, Morell and Brull, 2010) Simply, we take short cuts and veer from standards in the interest of patient flow and these short cuts become the norm because we don’t “see” any extreme negative outcome. Overtime, these new norms push the boundaries more and more. Normalization of Deviance theory has been applied to the Challenger space shuttle accident. Before the space shuttle blew up, O-ring erosion problems were documented numerous times. Over many occurrences and time, the engineers and managers started believing that these flaws were acceptable. This deviance became the new norm UNTIL the space shuttle accident. This lecture will discuss some of the new norms that may be becoming acceptable in imaging and possible negative outcomes. The role of management in combatting Normalization of Deviance will be explored. Reference: Prielipp, R. C. (2010-05). The Normalization of Deviance Do We (Un)Knowingly Accept Doing the Wrong Thing?. Anesthesia and analgesia, 110(5), 1499-1502.doi:10.1213/ANE.0b013e3181d5adc5  

Crowley, S, Kath, K, Woodward, A, Jackowski, M, Normalization of Deviance: What Is Happening in Your Department (Sponsored by the Associated Sciences Consortium) (An Interactive Session).  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14000911.html