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[RC] Preventing treatment - terre

We have been nibbling around the edges of this subject for ages (with discussions of pull codes, and the Aussie letter to the WEG); kudos to Stagg for finally bringing it to the point where we can attempt to sink our teeth into it!
I work in human health care, specifically transfusion medicine (blood bank). Hospitals put a great deal of effort into investigating what they call "Adverse Events"--a serious adverse event can be anything from amputating the wrong limb to death; less serious errors include things like mislabelled specimens, wrong dosages, etc. In almost every case where there is a serious adverse event (in our case it would be an equine death), investigation reveals that there were dozens of "near misses" that were never reported. Usually this is due to reluctance to admit an error or get a colleague in trouble when "nothing really happened"; occasionally it's due to apathy or a lack of appreciation of how serious the consequences could have been. Had these 'near misses' been reported (and procedures changed to eliminate them), the adverse event could have been avoided.
This is what we need--more data, or as Jeannie says "better science". We do not have enough deaths (Thank God) to provide us with the needed insight as to "what goes wrong"--we need to analyse the "near misses" if we are going to see a clear pattern of what the factors are that put horses at risk. This is why it is so important that the pull codes be accurately reported. We need reports of treatments, including followup. We need input from the owner/riders as to their management procedures--feed, travel time and conditions, electrolyting protocols, equine 'disposition', previous histories, etc. It would perhaps be even MORE valuable if we could gather reports on people who experienced problems and successfully dealt with them--stayed longer in the hold, fed something different, changed tack, whatever; because these people may have completed that data will be difficult to gather.
There is little value in changing rules or procedures without clear evidence that the changes will help. Because lowering the pulse requirement from 78 to 64 helped it doesn't necessarily follow that lowering it to 56 will help even more. Nor does requiring 'qualification'--it may not be newbies that are crashing the bulk of the horses. We need: a)to establish a protocol for accurately reporting all treatments, all deaths, and ideally even horses that were experiencing problems but successfully completed after a change in handling. This would involve drafting a form aimed at collecting as much data as possible, and not just the obvious questions of what happened during the ride.
b)to establish a committee (not necessarily the AERC vet committee) to review and analyse the data c)a means for this committee to follow up with the riders if necessary, or at a given time post-'event'--say two months--to see how the horse fared long term d)a report back to AERC (at least the BOD and Vet committee) within a given time frame (say 2 years) with specific recommendations.
A gargantuan task! Perhaps, but it is time we 'put our money where our mouth is' and invested some serious effort in this project. There are members (myself included) who have (or can get) some "draft procedures" from other venues (such as Health Care or industry) on how to get started. But we (AERC) need to put the ball in play.


Terre (#2548)


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