Surgical Checklists
Every year, 2,700 surgical patients go home from the hospital with metal tools, sponges, and other objects left inside them. In 2000, fifty-seven people died as a result of these mistakes.
I would actually say that this number is lower than expected. Here’s a perfect tool to save lives— the surgical checklist. Created by one of my mentors at Hopkins, Peter Provonost, it could reduce death by 40% every year…so what happened when Atul Gawande tried to implement it?
He met “significant resistance” to the idea from surgeons, he said. About half said it made sense, 30% were unenthusiastic but complied and 20% said they thought it was a waste of time. Some refused to use it.
I’ve spent the better part of the past decade in operating rooms at over a dozen different hospitals in multiple cities while completing surgical training. In my experience the use of these checklists is now common practice. They are very useful tools and now a seamless part of the OR experience. Inspection of hospitals by independent accrediting firms (http://www.jointcommission.org/AboutUs/) have encouraged their adoption. Hospitals that do not adopt such practices risk losing their accreditation. None of the institutions at which I trained were considered “closed-loop” systems, suggesting that such change is possible in other models of care.
