Carl Horsley
@carlhorsley.bsky.social
Intensivist at Middlemore; Resilient Healthcare + Te Ao Māori; Clinical lead for System Safety @HQSCNZ ; MSc HF & System Safety, Lund. All musings my own
#medsky #safetysky #icu
#medsky #safetysky #icu
Pinned
Carl Horsley
@carlhorsley.bsky.social
· Jun 18
The Future of Patient Safety: A Journey from Human Error to System Safety
YouTube video by Perioperative Medicine Monash University
youtu.be
Delighted to share the keynote talk from the Monash Patient Safety and Human Factors conference.
It examines what do we mean by “patient safety?”, exploring the roots of current approaches and how they leave us blind to changing risk and our increasingly brittle systems.
youtu.be/cvGXYtNZ1o8?...
It examines what do we mean by “patient safety?”, exploring the roots of current approaches and how they leave us blind to changing risk and our increasingly brittle systems.
youtu.be/cvGXYtNZ1o8?...
Reposted by Carl Horsley
The NZ Endocrine Society have released a statement calling for "the repeal of this unethical ban at the earliest opportunity". If it wasn't political, the govt would be listening to these expert statements. www.endocrinology.org.nz/nzse-positio...
New Zealand Society of Endocrinology - NZSE position on the ban of gonadotropin-releasing hormone analogues for the treatment of gender dysphoria or incongruence
www.endocrinology.org.nz
December 1, 2025 at 7:40 PM
The NZ Endocrine Society have released a statement calling for "the repeal of this unethical ban at the earliest opportunity". If it wasn't political, the govt would be listening to these expert statements. www.endocrinology.org.nz/nzse-positio...
Reposted by Carl Horsley
Worldwide mortality experience since the beginning of the COVID-19 pandemic (2020-2024) shows excess deaths over that period in almost every country measured. Australia (+6%) was below average, and New Zealand (+0.1%) the lowest we measured.
December 2, 2025 at 6:18 AM
Worldwide mortality experience since the beginning of the COVID-19 pandemic (2020-2024) shows excess deaths over that period in almost every country measured. Australia (+6%) was below average, and New Zealand (+0.1%) the lowest we measured.
Timeliness is not the overriding marker of the quality of care we should be focused on.
Quality is related to how well care meets the differentiated needs of those who seek care.
This goes back to the original description from Deming.
Don't mistake a measure for the aim .
Quality is related to how well care meets the differentiated needs of those who seek care.
This goes back to the original description from Deming.
Don't mistake a measure for the aim .
December 2, 2025 at 4:13 AM
Timeliness is not the overriding marker of the quality of care we should be focused on.
Quality is related to how well care meets the differentiated needs of those who seek care.
This goes back to the original description from Deming.
Don't mistake a measure for the aim .
Quality is related to how well care meets the differentiated needs of those who seek care.
This goes back to the original description from Deming.
Don't mistake a measure for the aim .
Reposted by Carl Horsley
Health NZ should use the $500 million that @clrenney.bsky.social pointed out has not been spent.
youtu.be/RqdjXKSIMi4
youtu.be/RqdjXKSIMi4
November 28, 2025 at 1:37 PM
Health NZ should use the $500 million that @clrenney.bsky.social pointed out has not been spent.
youtu.be/RqdjXKSIMi4
youtu.be/RqdjXKSIMi4
Reposted by Carl Horsley
We've just published the programme for the Capital City Complex Systems Symposium 2026, and registrations are open 👀
#cccss26 #complexsystems
www.tepunahamatatini.ac.nz/conferences/...
#cccss26 #complexsystems
www.tepunahamatatini.ac.nz/conferences/...
Capital City Complex Systems Symposium 2026
The Capital City Complex Systems Symposium 2026 explores cutting-edge knowledge of complex systems & complexity & how this knowledge is used to drive system change.
www.tepunahamatatini.ac.nz
November 27, 2025 at 11:17 PM
We've just published the programme for the Capital City Complex Systems Symposium 2026, and registrations are open 👀
#cccss26 #complexsystems
www.tepunahamatatini.ac.nz/conferences/...
#cccss26 #complexsystems
www.tepunahamatatini.ac.nz/conferences/...
Reposted by Carl Horsley
Reposted by Carl Horsley
#NZpol
Absolutely unacceptable given rising unemployment overall + losing plane after plane of good people offshore!
PSA's Fleur Fitzsimons:
"These figures show that delays in recruitment are a deliberate cost-saving tactic, driven by the government's failure to fund the health system properly."
Absolutely unacceptable given rising unemployment overall + losing plane after plane of good people offshore!
PSA's Fleur Fitzsimons:
"These figures show that delays in recruitment are a deliberate cost-saving tactic, driven by the government's failure to fund the health system properly."
Wellington Hospitals waiting up to six months for Health NZ approval to recruit
Data obtained under the Official Information Act shows 219 recruitment requests took more than two months to be approved, 91 waited more than 20 weeks, and 45 roles applied for in March were still vac...
www.rnz.co.nz
November 26, 2025 at 11:35 PM
#NZpol
Absolutely unacceptable given rising unemployment overall + losing plane after plane of good people offshore!
PSA's Fleur Fitzsimons:
"These figures show that delays in recruitment are a deliberate cost-saving tactic, driven by the government's failure to fund the health system properly."
Absolutely unacceptable given rising unemployment overall + losing plane after plane of good people offshore!
PSA's Fleur Fitzsimons:
"These figures show that delays in recruitment are a deliberate cost-saving tactic, driven by the government's failure to fund the health system properly."
Reposted by Carl Horsley
No, sorry, I mean, fucking Christ, how many nurses is that we could have kept in ANZ? How many radiologists/radiographers is it? Enough to clear the eight-month wait list for a basic CT?
As Craig Renney revealed to a shocked Dr Gary Payinda, Te Whatu Ora underspent its wages budget by $500m which has been signed off by Willis & returned to general coffers. Let that sink in. The money was there, but they deliberately underspent. On orders?
November 27, 2025 at 1:06 AM
No, sorry, I mean, fucking Christ, how many nurses is that we could have kept in ANZ? How many radiologists/radiographers is it? Enough to clear the eight-month wait list for a basic CT?
Reposted by Carl Horsley
“NZ is like mainly two large islands?”
“Yeah”
“So you must have a good ferry link”
“Our ferries are old and break down often”
“So you’ve got big tugs?”
“Minister of Transport just cancelled the tug. Said it wasn’t needed”
“Oh I guess the water is pretty calm”
“Rough as guts. Sunk a ferry once.
“Yeah”
“So you must have a good ferry link”
“Our ferries are old and break down often”
“So you’ve got big tugs?”
“Minister of Transport just cancelled the tug. Said it wasn’t needed”
“Oh I guess the water is pretty calm”
“Rough as guts. Sunk a ferry once.
November 24, 2025 at 11:16 PM
“NZ is like mainly two large islands?”
“Yeah”
“So you must have a good ferry link”
“Our ferries are old and break down often”
“So you’ve got big tugs?”
“Minister of Transport just cancelled the tug. Said it wasn’t needed”
“Oh I guess the water is pretty calm”
“Rough as guts. Sunk a ferry once.
“Yeah”
“So you must have a good ferry link”
“Our ferries are old and break down often”
“So you’ve got big tugs?”
“Minister of Transport just cancelled the tug. Said it wasn’t needed”
“Oh I guess the water is pretty calm”
“Rough as guts. Sunk a ferry once.
Reposted by Carl Horsley
Mike Hosking is wrong about the results of the UK Covid Inquiry this morning. The inquiry found an earlier lockdown could have saved 23k lives. It did find that "stringent restrictions short of a mandatory lockdown" if imposed earlier could have avoided a lockdown – which is diff from "unnecessary".
November 23, 2025 at 10:48 PM
Mike Hosking is wrong about the results of the UK Covid Inquiry this morning. The inquiry found an earlier lockdown could have saved 23k lives. It did find that "stringent restrictions short of a mandatory lockdown" if imposed earlier could have avoided a lockdown – which is diff from "unnecessary".
Reposted by Carl Horsley
Politicians constantly claim that the government must “live within its means”, just like any family.
In this video, I explain why the household analogy is not only wrong — it is the foundation of austerity.
youtu.be/Q03GKwMxmAo?...
In this video, I explain why the household analogy is not only wrong — it is the foundation of austerity.
youtu.be/Q03GKwMxmAo?...
Why the government is nothing like a household
YouTube video by Richard J Murphy
youtu.be
November 23, 2025 at 7:07 AM
Politicians constantly claim that the government must “live within its means”, just like any family.
In this video, I explain why the household analogy is not only wrong — it is the foundation of austerity.
youtu.be/Q03GKwMxmAo?...
In this video, I explain why the household analogy is not only wrong — it is the foundation of austerity.
youtu.be/Q03GKwMxmAo?...
Efficiency thoroughness tradeoff and the law of stretched systems...
November 23, 2025 at 6:07 PM
Efficiency thoroughness tradeoff and the law of stretched systems...
Reposted by Carl Horsley
Jaimie Veale, the founding president of PATHA and Director of the Trans Health Research Lab at Waikato has written an excellent op-ed for the Conversation: "The government has placed a burden of proof on puberty blockers that we do not place on other paediatric care."
Puberty blockers: why politicians overriding doctors sets a dangerous precedent
The government’s ban on puberty blockers undermines clinical expertise and targets trans youth with a policy that lacks evidence, consistency and fairness.
theconversation.com
November 21, 2025 at 3:06 AM
Jaimie Veale, the founding president of PATHA and Director of the Trans Health Research Lab at Waikato has written an excellent op-ed for the Conversation: "The government has placed a burden of proof on puberty blockers that we do not place on other paediatric care."
Reposted by Carl Horsley
Very proud to have been able to contribute to this response from the NZNO College of Child and Youth Nurses to the puberty blocker ban. I'm glad our union and college have our back and are willing to stand up to this transphobic government.
www.nzno.org.nz/about_us/med...
www.nzno.org.nz/about_us/med...
Puberty blocker ban will hurt young people: Child and Youth nurses
The decision to ban new prescriptions for puberty blockers will hurt young people, the NZNO College of Child and Youth Nurses (CCYN) Tapuhitia Ngā Mokopuna Mō Apōpō says. Minister of Health Simeon Br...
www.nzno.org.nz
November 20, 2025 at 3:21 AM
Very proud to have been able to contribute to this response from the NZNO College of Child and Youth Nurses to the puberty blocker ban. I'm glad our union and college have our back and are willing to stand up to this transphobic government.
www.nzno.org.nz/about_us/med...
www.nzno.org.nz/about_us/med...
Reposted by Carl Horsley
Autocorrect has become our worst enema.
November 19, 2025 at 10:04 PM
Autocorrect has become our worst enema.
This is very wrong from a safety science view.
Accidents do not just "happen", they are the emergent outcomes of a system. A purely business centric view drives a focus on costs, activity and profit, contributing to the rise of increasing risks.
Rasmussen 1997
Accidents do not just "happen", they are the emergent outcomes of a system. A purely business centric view drives a focus on costs, activity and profit, contributing to the rise of increasing risks.
Rasmussen 1997
November 19, 2025 at 7:02 PM
This is very wrong from a safety science view.
Accidents do not just "happen", they are the emergent outcomes of a system. A purely business centric view drives a focus on costs, activity and profit, contributing to the rise of increasing risks.
Rasmussen 1997
Accidents do not just "happen", they are the emergent outcomes of a system. A purely business centric view drives a focus on costs, activity and profit, contributing to the rise of increasing risks.
Rasmussen 1997
Reposted by Carl Horsley
That last line is FIRE 🔥
Christiane Amanpour, "Antisemitism is a major problem. How do you navigate that?"
Zack Polanski, "I think it is a powerful message to have a Jewish leader and a Muslim deputy leader"
"Antisemitism and Islamophobia are two sides of the same coin"
"And the best response to hatred is solidarity"
Zack Polanski, "I think it is a powerful message to have a Jewish leader and a Muslim deputy leader"
"Antisemitism and Islamophobia are two sides of the same coin"
"And the best response to hatred is solidarity"
November 14, 2025 at 8:44 AM
That last line is FIRE 🔥
Reposted by Carl Horsley
Labour selects Dr Gary Payinda to take on former Health Minister Dr Shane Reti
Labour selects Dr Gary Payinda to take on former Health Minister Dr Shane Reti
A high-profile emergency doctor has been selected to stand for the Labour Party against former Health Minister Dr Shane Reti.
www.rnz.co.nz
November 17, 2025 at 12:00 AM
Labour selects Dr Gary Payinda to take on former Health Minister Dr Shane Reti
Reposted by Carl Horsley
"If you're not careful, the newspapers will have you hating the people who are being oppressed and loving the people who are doing the oppressing." Malcolm X.
www.theguardian.com/commentisfre...
www.theguardian.com/commentisfre...
Dark forces are preventing us fighting the climate crisis – by taking knowledge hostage | George Monbiot
The fundamental problem is this: that most of the means of communication are owned or influenced by the very rich, says Guardian columnist George Monbiot
www.theguardian.com
November 16, 2025 at 10:41 AM
"If you're not careful, the newspapers will have you hating the people who are being oppressed and loving the people who are doing the oppressing." Malcolm X.
www.theguardian.com/commentisfre...
www.theguardian.com/commentisfre...
Reposted by Carl Horsley
Deeply grateful to the cops who pushed hard against this, the journos like Paula who get the sunlight disinfectant out, & Ms Z who has been victimised at every turn.
These are the five senior officers who come in for the most criticism in the IPCA report on the McSkimming scandal.
Revealed: The five senior officers at the heart of the McSkimming 'cover-up'
The IPCA report on the handling of the McSkimming case identifies a string of complicit senior officers. So who are they?
www.stuff.co.nz
November 12, 2025 at 7:35 AM
Deeply grateful to the cops who pushed hard against this, the journos like Paula who get the sunlight disinfectant out, & Ms Z who has been victimised at every turn.
Reposted by Carl Horsley
"Aotearoa plummets from 2nd to 53rd in Global Tobacco Industry Interference Index ranking"
NZ getting back on track - to those times when tobacco lobbyists had free reign #nzpol
www.phcc.org.nz/briefing/aot...
NZ getting back on track - to those times when tobacco lobbyists had free reign #nzpol
www.phcc.org.nz/briefing/aot...
Aotearoa plummets from 2nd to 53rd in Global Tobacco Industry Interference Index ranking
Recent policy changes have led to a dramatic drop in NZ’s global ranking for tobacco interference protection.
www.phcc.org.nz
November 12, 2025 at 5:19 AM
"Aotearoa plummets from 2nd to 53rd in Global Tobacco Industry Interference Index ranking"
NZ getting back on track - to those times when tobacco lobbyists had free reign #nzpol
www.phcc.org.nz/briefing/aot...
NZ getting back on track - to those times when tobacco lobbyists had free reign #nzpol
www.phcc.org.nz/briefing/aot...
Reposted by Carl Horsley
We are supposed to honour our agreements, and that's what a treaty is! - please sign: our.actionstation.org.nz/petitions/pr...
Protect Te Tiriti in Education
Aotearoa should be a place where everyone, regardless of their background, is respected and part of a vibrant connected community. Where everyone feels a sense of belonging and knows their children wi...
our.actionstation.org.nz
November 11, 2025 at 6:31 AM
We are supposed to honour our agreements, and that's what a treaty is! - please sign: our.actionstation.org.nz/petitions/pr...
Reposted by Carl Horsley
“Wow I can't believe that 40 years of maximizing shareholder value at the expense of everything else didn't improve society at all.”
🤷♀️ #nzpol
🤷♀️ #nzpol
November 8, 2025 at 7:47 AM
“Wow I can't believe that 40 years of maximizing shareholder value at the expense of everything else didn't improve society at all.”
🤷♀️ #nzpol
🤷♀️ #nzpol
Reposted by Carl Horsley
Paywall lifted: At every turn, the Govt has opted for whatever would actually lead to more pollution and a warmer world – even if it costs more, jeopardises NZ’s reputation, overturns a campaign promise or clashes with the Govt’s other priorities.
The long retreat:
newsroom.co.nz/2025/11/07/g...
The long retreat:
newsroom.co.nz/2025/11/07/g...
Govt's climate strategy: Let it burn
Comment: The Government has relentlessly pursued policies that boost climate pollution – even if they cost more or jeopardise NZ's reputation, Marc Daalder writes
newsroom.co.nz
November 7, 2025 at 6:33 PM
Paywall lifted: At every turn, the Govt has opted for whatever would actually lead to more pollution and a warmer world – even if it costs more, jeopardises NZ’s reputation, overturns a campaign promise or clashes with the Govt’s other priorities.
The long retreat:
newsroom.co.nz/2025/11/07/g...
The long retreat:
newsroom.co.nz/2025/11/07/g...