CommonWealth Magazine’s terrific CommonWealth Unbound blog recently highlighted how a safety checklist can reduce the number of deaths from hospital-acquired infections.
According to the author, a flight training manual developed in 1980s states the following, “[E]ven the most experienced professional pilots never attempt to fly without an appropriate checklist. The habit of using a written checklist … should be so instilled in pilots that they will follow this practice throughout their flying activities.” Some 80% of all general aviation accidents in the United States are caused by errors on behalf of the pilot. One missed step in the pre-flight process could cost a life and, therefore, the use of a checklist has become an industry standard. It is only recently that the medical community has discovered the benefits of using a checklist.
Now, 100,000 people die each year from hospital-acquired infections. It is the 10th leading cause of death in the United States. The author states, referring to Dr. Peter Pronovost, who created a checklist to prevent infections, “Dr. Pronovost found that making a habit of using this checklist every time, for every patient, by every caregiver, had dramatic results. He proved that use of this checklist in surgical ICUs had dramatically reduced the number of catheter-related blood stream infections in patients.” However, as the author observes, despite the success of a checklist, many hospitals around the country and in Massachusetts have not systematically implemented checklists.
As we’ve blogged, the Consumer Health Quality Council, a unique HCFA coalition of consumers who have been impacted by poor quality care, has worked with legislators to file three bills, one of which encourages the use of checklists of care in hospitals in the Commonwealth. Should the bill pass and become law, perhaps the high numbers of infections and medical errors will, as Brown suggests in the article, become “a thing of the past.”
Kuong Ly
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I am a Boston-area medical student and regular reader of a Healthy Blog. I read the blog consistently because I feel that it reports on important issues, and while I do not always agree with the opinions expressed, I am open to the points of view expressed herein.
However, I feel that there is, at times, an undertone of animosity and distrust of the health care community, particularly physicians, in the posts. As a future physician, this is disheartening. Health care, like any industry, is marred by instances of poor quality, excess and the like. Yet, there is also an immense amount of good that goes on everyday within health care. Lives are saved, patients are cured and prevention is achieved.
“What Doctors Can Learn from Pilots” points out the utility of checklists in medicine, and rightly so. I’m not naive to these issues, as I’m also earning my MBA in conjunction with my MD. The business teachings that I am exposed to are entirely in line with the goals of cost-containment, efficiency and improved quality. However, I don’t believe that the lack of such things in health care necessitates an underlying tone of blame towards a particular group (physicians). Health care delivery is carried out in an increasingly complex system that constrains providers in many ways and does not necessarily allow for the type of high quality, efficient care that we would all would like to see achieved. While pointing out ways to improve the system is necessary and needed for improvement sake, it might be done in a manner more reflective of the complexities within which providers work.
I will remain a loyal reader, but as a medical student it would be nice to see a post concerning the ‘good’ that is happening in the medical field. I see this good when working with patients; I also see the many inefficiencies of the system that are addressed by this blog. So, while in agreement with many of the opinions expressed herein, I also feel that what is right with the system is underexposed.