Comments on: How a Checklist Can Improve Health Care

By: Checklists. The horror « (the) health informaticist

Checklists. The horror « (the) health informaticist — Sat, 12 Apr 2008 11:00:13 +0000

[...] a checklist. Healthcare professionals apparently don’t like following checklists; here is a blog entry, and an extract, about it… … a must-read for anyone who wants to know more about what [...]

By: Jim Carney, PA-C

Jim Carney, PA-C — Sat, 05 Jan 2008 14:53:19 +0000

I work in one of the ICUs that is part of Dr. Pronovost’s intitiative in Rhode Island. To the best of my knowledge the feds have not told us we can’t use checklists.

By: Charlie Baker

Charlie Baker — Tue, 18 Dec 2007 20:43:03 +0000

AM - Read the Gawande article. He talks about the evolution of the checklist in aviation - and how, when and why the airline industry adopted checklists for take-off and landing. Pretty interesting stuff.

By: Charlie Baker

Charlie Baker — Tue, 18 Dec 2007 20:29:35 +0000

Thanks for sharing, Paul. Very much appreciated. I also heard from a friend of mine who’s a provider who told me that the federal government recently shut down all of Pronovost’s work at Hopkins and in Michigan, and his embryonic efforts to put something similar in place in Rhode Island, arguing it was a research project, and therefore, required every patient’s consent before using the checklist. If true, this is a shame, because Pronovost’s work was a thoughtful approach to a difficult problem. Anybody out there know if this is true?

By: AM

AM — Tue, 18 Dec 2007 19:47:09 +0000

People always say “if the airline industry had the same record of safety as the healthcare system, a plane would be going down every second!”

Funny thing, though - they don’t. But they do use a checklist before every take-off. And they use it religiously. I can’t tell you how many times I’ve seen a pilot inspecting the plane before it’s flown; walking around the outside, kicking the tires. I don’t know how often surgeons (or physicians in general) do the same thing.

Seems to me, we could learn something from the airlines…

Hmmm.

By: Paul Levy

Paul Levy — Tue, 18 Dec 2007 16:33:05 +0000

Atul is a wonderful author and is right on target in so many ways. Here is another example, a summary of BIDMC’s results with regard to central line infections: http://runningahospital.blogspot.com/2007/05/central-line-infection-report.html#links. And another on reducing ventilator associated pneumonia: http://runningahospital.blogspot.com/2007/05/central-line-infection-report.html#links.

Whether it is a check list or a redesign of work flows, there are many, many opportunities for quality and safety improvement in hospitals.