Tag Archives: checklists

Where have all the patient safety activists gone? … Answer: They’re still around, just a bit quieter

Today, Sept. 17, is the first World Patient Safety Day, declared by the World Health Organization to draw attention to ever-present need – still – to reduce avoidable patient harm in health care settings.

And November marks the 20th anniversary of “To Err is Human,” the National Academy of Medicine’s 1999 report that estimated as many as 98,000 people die a year in United States hospitals. That widely publicized report called for a national agenda to improve patient care processes to make it easier for honest providers to safely treat patients and harder for them to cause harm. Continue reading

Formula 1 pit crews inspire physicians

In American Medical News, Kevin O’Reilly examines a study of the lessons physicians have learned from the high-speed ballet of precision-drilled Formula 1 pit crews. After all, those tire-changing automatons have perfected the sort of routine that medicine’s checklist advocates have been preaching for some time. Because their actions are so specific, the F1 crews provide a seductive example of the efficiency that can be gained through practice, databases and, of course, checklists.

Photo by usag.yongsan via Flickr

“At the moment, we kind of say, ‘Well, we do it this way.’ Everybody thinks they know really what happens, but not everyone does,” (lead author Ken Catchpole, PhD) said. “There is lots of individual variation that creeps into these things. Sometimes that’s good, and it’s responsive to individual patients. But often that creates these uncertainties that increase the opportunities for errors to happen.”

Catchpole has helped physicians at London’s Great Ormond Street Hospital for Children use F1 techniques to improve their handoff of pediatric heart surgery patients to intensive care, with results first published in the May 2007 issue of Pediatric Anesthesia. New protocols developed in response to video examination of pit stops and visits with F1 racing crews helped cut the duration of patient handoffs and reduced omissions of critical information and technical errors by 67%, the study showed.

For more, see Fierce Healthcare’s Dan Bowman to brief exploration of medicine’s fascination with Formula 1.

In addition to lives, checklists save money

Last year, Atul Gawande and company made a splash by showing what a profound clinical impact checklists made on patient outcomes. Now they’re back, but this time the checklist evangelists are aiming for the pocket book. In the latest Health Affairs, Gawande and seven others contributed a paper with the descriptive title “Adopting A Surgical Safety Checklist Could Save Money And Improve The Quality Of Care In U.S. Hospitals.”

preflightPhoto by cybrjoe via Flickr

Here’s their arithmetic, courtesy of The Boston Globe‘s Elizabeth Cooney

Time was the biggest cost in setting up the checklist, Gawande and his co-authors write in the journal Health Affairs. They estimated that a hospital with at least a 3 percent rate of complications per year would begin to see savings after five major complications were prevented. That means a hospital where 4,000 noncardiac operations were done each year could save about $25 on each procedure, or about $100,000 annually, they concluded.

As always, free access to Health Affairs studies is one of many perks enjoyed by AHCJ members.