Biggest hazards can be fought with a checklist
BNET's David Hamilton pointed me to the ECRI's annual list of the top technology hazards in hospitals, and one point leapt out.
Most of these hazards are easily fought with a checklist. (Picture from Remaking American Medicine.)
I first wrote about checklists in December, 2007, and then found that advocate Peter Pronovost (pictured) won a genius award for the idea the following September.
But just examine the hazards:
- 1. Alarm Hazards -- Faulty setting of alarms can be mitigated by following a checklist on the procedure.
2. Needlesticks and Other Sharp Injuries -- A checklist slows the process of putting a sharp needle in someone, but also improves its safety
3. Air Embolism from Contrast Media Injectors -- Preventing air bubbles from getting into dye injectors is a matter of training, but why not put that training inside the process?
4. Retained Devices and Un-retrieved Fragments Left in Patients -- RFID can tag and help retrieve what goes into a patient, but a checklist can do it for less.
5. Surgical Fires can happen when you're not paying attention to what a laser or cauterizer is doing. It can also happen if you're putting alcohol or oxygen too near the site. A checklist can keep this from happening.
In my first story on Pronovost I noted that he recommended nurses control the checklist. They are better at it. It gives them power.
And the power issue is why checklists are not used more routinely. Doctors are like airline pilots and demand control. Fine, let them run the checklist.
So long as someone does have a checklist more people will live, there will be less malpractice, and the cost of hospital care will go down.