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Paul Preston, MD

Anesthesiology, San Francisco

Patient Safety

“I am fortunate that sometimes I get to be an agent of change. I do a lot of teaching, but I do even more learning. Often the best ideas I teach are concepts I have learned from my colleagues.”

Dr. Preston is not seeking perfection. “Perfection is impossible,” he says. “It’s okay not to be perfect. Rather, our job as clinicians is to work in a system and to be part of a team that does its best and also traps errors before they evolve and cause harm.”

Towards this end, for more than a decade, he has passionately embraced the science of patient safety and shared the latest techniques, tools and technologies with his colleagues throughout Northern California. Since 2003, Dr. Preston has made extensive use of Critical Event Team Training (CETT), which allows teams of providers to improve their response to emergency situations by practicing on realistic, computer-controlled, robotic mannequins. Simulation training is coupled with Human Factors Training, which teaches skills for team building and improved communication.

Dr. Preston has used this approach in the Perinatal Patient Safety Project to train multidisciplinary teams at all 12 KPNC medical centers that offer Labor and Delivery Services. He also has done trainings for staff in Cardiac Catheterization Labs and Operating Rooms, and with members of Rapid Response Teams around the region. CETT not only gives the staff practice in handling emergency situations, it helps uncover flaws in the system, so that they can be fixed.

Most recently, Dr. Preston has focused on surgical safety, through the creation of Highly Reliable Surgical Teams that use communications practices, such as pre-anesthesia briefings, that have been proven to reduce errors.

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