Inside Health Care: Evidence Patient Safety Improves With a Checklist

CFAH Staff | February 8, 2011

Medical students commonly ask family doctor Dr. Davis Liu how they can become more efficient at taking a patient history. He advises that the 'most important part of being a doctor is talking to patients and listening,' and that 'taking a good history is the essential part of being a good doctor.' Dr. Davis Liu compares getting a good history to checklists pilots use, citing writer and surgeon Dr. Atul Gawande who advocates for checklists to reduce errors in health care. Dr. Davis Liu says, 'Taking a good history also slows doctors down and allows them to avoid cognitive errors, think more clearly, and avoid jumping to premature conclusions.'

The health team that operated on Congresswoman Gabrielle Giffords may agree with Gawande and Liu. The Associated Press reports that Trauma surgeon Dr. Randall Friese was the first to treat Giffords by coordinating her care through a 'checklist much like what a pilot would do before taking off.'

A study out last week in the British Medical Journal found that the safety checklist program developed by Johns Hopkins doctor, Peter J. Pronovost, reduced patient deaths in Michigan hospitals by 10 percent, in addition to eliminating bloodstream infections in participating health care facilities. Paul Levy, former hospital CEO, asks, 'How long will it take for this approach to be used across the country?' He thinks most will say this program will not work for them and that their 'patients are sicker.' Levy proposes 'jump-starting' the use of checklists by publishing a monthly rate of central line infections on a public website. 'Then, you would see the power of transparency,' Levy says.

Fifth year medical student, Ishani Ganguli , also writes about the results of the BMJ study and patient safety, 'To the average future doctor, these sorts of efforts, and the skills to engage in them, are probably unfamiliar.' Learning about quality improvement processes in medical school is scarce.'  Medical students have to seek out opportunities if they want to be involved in the patient safety movement. Ganguli has by attending the third annual Patient Safety and Quality Leadership Institute. She says, 'Student speakers were introduced with the same pomp and circumstance as deans.' Ganguli is hopeful for the future of patient safety, 'It's this sort of anti-hierarchical attitude that, if adopted widely from the top as well as the bottom, just might promote the culture we need for safer and better patient care.'

Dr. Davis Liu is a practicing board 'certified family physician and blogs at Saving Money and Surviving the HealthCare Crisis. Paul Levy, a former CEO of a large Boston Hospital, blogs at Not Running a Hospital. Ishani Ganguli,a journalist and doctor-in-training, blogs at Short White Coat as part of the White Coat Notes for The Boston Globe's health blog.

' By Sarah Jorgenson, CFAH' Communications and Research Associate

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Medical/Hospital Practice   CFAH Staff   Find Good Health Care   Accidents and Safety   Inside Healthcare  

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Tweets that mention Prepared Patient Forum: Inside Health Care: Evidence Patient Safety Improves With a Checklist « CFAH PPF Blog -- Topsy.com says February 8, 2011 at 3:20 PM [...] This post was mentioned on Twitter by Molly French, Jessie Gruman. Jessie Gruman said: Inside Health Care: Those Darn Checklists! Update on How They Affect Patient Safety: http://tinyurl.com/4bgrmk4 [...]

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