I felt pride when I read that it was not doctors but nurses who began using checklists in hospitals, checklists for giving medications and taking vital signs and checklists for gauging pain. How amazing that instituting checklists in ICU's brought down dramatically the infection rate among patients on central lines and also reduced the occurence of pneumonia among patients on ventilators.
There's a connection to education. This speaks to the importance of written lesson plans with goals. Of course I'm a veteran who knows what I'm teaching, but like these experienced physicians and airplane pilots that Gawande writes about, I am human and I get off track and I forget what I meant to do or say. Nobody's life is at risk in my classroom, but my students' time w/ me is limited, and I mustn't waste it!
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It's interesting that you mentioned a way the nurses came up with an idea that hospitals could use to help increase success rates in, what I would think would be called, unnecessary negative results. In the book I read, Switch, there was a man, Donald Berwick, a doctor and the CEO of the Institute for Healthcare Improvement (IHI), who said that he was going to save 100,000 lives in 18 months. 100,000 lives that were unnecessary deaths.
ReplyDelete"IHI proposed six very speciļ¬c interventions to save lives. For instance, one asked hospitals to adopt a set of proven procedures for managing patients on ventilators, to prevent them from getting pneumonia, a common cause of unnecessary death. (One of the procedures called for a patient's head to be elevated between 30 and 45 degrees, so that oral secretions couldn't get into the windpipe.)"
He saved lives, or rather helped other people save lives. What's the difference anyways? So I think the main point I am trying to convey is that just by doing simple things like that checklist or that proven method of care, you can create change. Big change.