The Increasing Codification and Transparency of Hospital Practice

Ah the halcyon days, when at the age of 26 I was the most senior obstetrician on site in a huge high-risk hospital. How times have changed. Now a fully accredited specialist must be on hand, she must follow check-lists, and cognitive aids will try to pre-empt errors.[1] And now we hear that she will be under video-surveillance for a substantial portion of her working life.[2] Of course all of this is a good thing – codification reduces error in all industries. And we must also realise that codification does not mean that the need for judgement is vitiated, or that medicine cannot still be fun and even heroic, as we have argued before.[3] And transparency is also no bad thing; as it punishes those who transgress so it exonerates the many who are falsely accused.

— Richard Lilford, CLAHRC WM Director


  1. Merry AF, Mitchell SJ. Advancing Patient Safety Through the Use of Cognitive Aids. BMJ Qual Saf. 2016; 25(10):733-5.
  2. Joo S, Xu T, Makary MA. Video transparency: a powerful tool for patient safety and quality improvement. BMJ Qual Saf. 2016; 25: 911-3.
  3. Lilford RJ. Can We Do Without Heroism in Health Care? NIHR CLAHRC West Midlands News Blog. March 20, 2015.

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