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Last updated: February 24, 2010
Jon Stewart may be one of the few people who can use humor while discussing patient safety and still manage to raise good points. He asked in his show earlier this month: Would more hospitals adopt safety checklists if we classified hospital infections as terrorists?
“Even Han and Chewy went through a checklist, and they were traveling in hyperspace!” joked Stewart.
Atul Gawande, his guest talking about his new book, noted that surgical checklists, which include making sure patients have antibiotics, (they should receive them within 60 minutes of the operation) have cut infection deaths by over one third in the first 8 hospitals who adopted it. (To see how well your hospital follows this step, go to CU’s Stop Hospital Infections website.) Yet only 20 percent of American hospitals follow these checklists, he noted. But if given the option, 93 percent of doctors would prefer that a checklist were used if he or she were going under the knife.
The recent Consumer Reports article, “Deadly infections,” included information about a life-saving checklist developed by Peter Pronovost, M.D., Ph.D., that has been proven to prevent hospital-acquired infections from central-line catheters.
The checklist translated the most effective known approaches into a common-sense series of hygienic precautions to follow when inserting, using, or removing a central line. The steps require equipment no more complex than hand soap, an antiseptic solution, and sterile drapes and garb. Other key components: giving nurses the authority to make doctors follow all the steps, and measuring and reporting infection rates.
When put to use, common sense saves lives. Sixty-seven Michigan hospitals implemented Pronovost’s checklist program and had dramatic results: a 66 percent reduction in central-line-associated bloodstream infections; an estimated 1,500 lives and $200 million were saved in the first 18 months alone.
Even so, many hospitals aren’t bothering to sign up. Gawande attributed it to the complexity of the medical field. He believes hospitals should look to the aviation field, similar to using a pilot’s checklist. The aviation industry adopted a checklist in reaction to the Boeing B-17 Bomber Crash in 1943.
Patient safety activist Michael Bennett put an exclamation on Gawande’s analogy with the airline industry. “The Boeing checklist that he referred to was implemented as a consequence of a single incident that happened almost 70 years ago. Hospital-acquired infections have been a runaway problem for decades, if not longer, and whatever progress has been made (and it’s not enough) has been driven by consumers while the medical industry is barking, dodging, and weaving. The difference with the airline industry is that the pilots die just as dead as do the passengers when the plane crashes AND there is still accountability!”
Peter Pronovost believes public accountability powerfully motivates hospitals to reduce their infection rates. We certainly agree. That’s why our campaign has been working since 2003 to require all hospitals to publicly disclose their infection rates. Shortly after Consumer Reports released its article, the federal Centers for Disease Control and Prevention (CDC) announced support for public reporting of infection rates, along with the Association for Professionals in Infection Control and Epidemiology (APIC) and the Society for Healthcare Epidemiology of America (SHEA).