Thursday, January 15, 2009

Surgery Kills For Lack of 2 Minute Checklist

On the radio this morning the newscaster reported that "1.5 million people die needlessly from surgeries. A simple 2 minute checklist could have prevented these tragedies."

What was interesting was that the announcer said it without even considering what he was saying. Hmm. 1.5 million people killed due to the negligence of a team of professionals where each surgery cost in excess of tens of thousands of dollars.

3,500 hundred people were killed at the suicide bombing of the World Trade center. How many billions, maybe trillions have been spent in response to this act. But when our trusted medical teams kill tens of thousands of people because they didn't take proper medical precautions we get a 15 second sound bite on the radio that doesn't impact anyone with its shocking numbers.

I think the 1.5 million was an exaggeration but here's the article below that the newscaster was likely quoting from.

Studies: Surgeons could save lives, $20B by using checklist
By: Liz Szabo USA Today

Eight hospitals reduced the number of deaths from surgery by more than 40% by using a checklist that helps doctors and nurses avoid errors, according to a report released online today in the New England Journal of Medicine.

If all hospitals used the same checklist, they could save tens of thousands of lives and $20 billion in medical costs each year, says author Atul Gawande, a surgeon and associate professor at the Harvard School of Public Health.

ON THE WEB: Read the full 'New England Journal of Medicine' article
VIDEO: WHO shows how to use the checklist

The 19-point checklist has nothing to do with high technology, Gawande says. Instead, it focuses on basic safety measures, such as ensuring that patients get antibiotics to prevent infection and requiring that all members of the team introduce themselves.

"An operation involves hundreds of steps with lots of team members," Gawande says. "We're good at making sure we do most of these things most of the time, but we're not good at doing all of them all of the time."

In his study, which was funded by the World Health Organization, hospitals reduced their rate of death after surgery from 1.5% to 0.8%. They also trimmed the number of complications from 11% to 7%.

The study shows that an operation's success depends far more on teamwork and clear communication than the brilliance of individual doctors, says co-author Alex Haynes, also of Harvard. And that's good news, he says, because it means hospitals everywhere can improve.

Researchers modeled the checklist, which takes only two minutes to go through, after ones used by the aviation industry, which has dramatically reduced the number of crashes in recent years.

Gawande says the checklist may have saved one of his own patients.

Before an operation recently, Gawande told his team that the operation might be longer, bloodier and more complicated than usual. An anesthesiologist made sure to have an extra supply of blood on hand. If the team had had to call on the hospital blood bank — and take time to get the right type — the patient could have died, he says.

Safety organizations around the world have pledged to get hospitals on board. Four countries — the United Kingdom, Ireland, Jordan and the Philippines — already have plans to use the checklist in all operations.

It usually takes 17 years for medical advances to become standard practice, says Joe McCannon, vice president of the Institute for Healthcare Improvement, which works with 4,000 American hospitals on improving quality. He wants the country to move much faster this time by having all U.S. hospitals try the checklist by April 1.

"Patients deserve it, and they deserve it now," McCannon says.

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