With patients’ health and lives at stake when receiving care for surgeries and other serious medical procedures, doctors and hospitals take special precautions to ensure a safe outcome. While many hospitals provide checklists to their patients with instructions to follow prior to admittance to a hospital stay, experienced doctors often resist hospital checklists as an insult to their intelligence.
However, studies have found that checklists do not only help physicians and medical teams avoid medical errors such as surgical implements left in patients and wrong-site surgeries, but they also enhance their effectiveness. Checklists also provide both the hospital and staff with paper trial to review when something goes wrong during a procedure. Those procedures can help health care professionals avoid a costly medical malpractice claim.
According to a 2007 article in The New Yorker, Peter Pronovost, a critical-care specialist at Johns Hopkins Hospital, advocated for a simple surgical checklist meant to eliminate infections caused by inserting lines in patients. After two years of following the checklist, the hospital dropped its infection rate in this area to virtually zero and estimated that the checklist had saved as many as 10 lives and millions of dollars in costs.
Even so, some doctors resist implementing something so simple that could be perceived as challenging their intelligence. In a June article, Kaiser News reported that doctors who take the time to verify the surgical site and procedure with patients before starting surgery are less likely to make a mistake than those that take a passive approach by asking the staff to speak up if something seems wrong. Staff members may remain silent if they are uncertain rather than challenging the surgeon. “There’s a big difference between hospitals that take care of patients and those that take care of doctors,” said John Clarke, clinical director of the Pennsylvania Patient Safety Authority. “The staff needs to believe the hospital will back them against even the biggest surgeon.”
Sometimes it takes an error to result in a checklist being implemented. Surgeon David C. Ring of Massachusetts General Hospital discovered after a surgery that he performed the wrong one — correcting carpal tunnel syndrome instead of trigger finger release. He said, “It was the worst feeling of my life: The ground literally falls beneath you.”
Although the patient did not sue the hospital for medical malpractice, the hospital provided compensation to the patient. More importantly, the hospital implemented a checklist including a “timeout” before making the first incision to prevent similar errors in the future.
The New Yorker article sited an Israeli study where scientists found that the average intensive care patient needed 178 individual actions on a daily basis, ranging from suctioning the lungs to administering a drug—and that every single one of them posed risks. With this many procedures being performed on just one patient, how can doctors not want a checklist?
AMA President Peter W. Carmel, MD., and a pediatric neurosurgeon in Newark, N.J sent a message “to all physicians” on August 1, advocating the use of medical checklists. “I am a big fan of these simple checklists,” Carmel said. “They are designed to make sure that in our focus on the complex we don’t overlook the obvious.”
He added, “Our jobs are tough enough. It is good to know that we have at our disposal simple tools like checklists and support organizations like the AMA watching our backs.”
Perhaps with such a strong statement from the AMA president more hospitals will begin implementing checklists. Sacred Heart Hospital Pensacola, Florida, as an example, has implemented the use of the “hourly rounding competency checklist” which focuses on ensuring that each patient is properly cared for during the hourly rounds that are made by the nursing staff. Not all checklists focus on a medical procedure, but all of them should focus on putting the safety of patients first.
If you suspect that you or a loved one has been harmed due to a medical error, turn to a South Florida medical malpractice attorney with more than 36 years of experience evaluating cases of medical malpractice and defective medical devices.
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