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Better patient safety: implementing exploration and exploitation learning in daily medical practice
  1. Ayala Kobo Greenhut1,
  2. Racheli Magnezi1,
  3. Izhar Ben Shlomo2,3
  1. 1Department of Management, Bar-IIan University, Ramat Gan, Israel
  2. 2Assisted Reproduction Unit, Department of Obstetrics and Gynecology, Baruch Padeh Medical Center, Tiberias, Israel
  3. 3Faculty of Medicine in the Galilee, Bar-Ilan University, Safed, Israel
  1. Correspondence to Professor Izhar Ben Shlomo; ibenshlomo{at}poria.heath.gov.il

Abstract

Background Current medical daily practice relies on guidelines, protocols and procedures (GPPs), which require exploitation. However, diagnosis, treatment, risk management and process improvements require exploration. Physician are often unable to switch between exploitation and exploration. This study tested a new approach to facilitate switching that included (1) a new ‘thinking protocol’ that encouraged leaping from exploitation to exploration and (2) a GPP that encouraged leaping from exploration to exploitation.

Method Two hundred students were divided into four groups. The groups received a set of tasks that required switching between exploitation and exploration. Three groups received the thinking protocol, the GPP, or both, and the fourth group served as control.

Results With each additional task, all groups increased exploitative tendency(p<0.0001). The two groups with the thinking protocol leaped from exploitation to exploration (p<0.0001); the other two groups remained in exploitation (p=0.1173, p=0.0758). For the groups that employed exploration learning, the group that received the GPP switched back to exploitation (p<0.0001), but the other group remained in exploration (p=0.2363).

Conclusion Despite the importance of timely leaping between exploration and exploitation, in some events, medical teams fail to make the appropriate leap. We suggest to use our novel approach and to encourage the leaping between exploration and exploitation in daily medical practice, to enable the prevention of medical errors and to enhance the effectiveness of risk managements and process improvements.

  • Quality Improvement
  • Continuous Quality Improvement
  • Healthcare Quality Improvement

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

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Footnotes

  • Contributors AKG and IBS planned the study design, and AKG performed the tests. All authors analysed the results and participated in the drafting and completion of the manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.