Using checklists in the ICU, a real world patient safety success story

Initially skeptical of using seemingly commonsense checklists in the intensive care setting, an infectious disease specialist is now a convert supporting the practice.

In his regular Washington Post piece, Manoj Jain writes about his hospital’s initiative in conjunction with patient safety guru Donald Berwick. The program, instituted in 2002, required checklists to be followed prior to common ICU procedures, such as the insertion of central lines, endotracheal tubes, or urinary catheters.

Some items on the checklist, such as wearing a sterile gown prior to placing a central line, seems to be obvious, but you’d be surprised at how many doctors ignore this step.

The results of the program were stunning, as Dr. Jain noted a “50 percent decline in our ICU infection rate, with a 21 percent (or $702) reduction in cost per ICU discharge.”

For a relatively straightforward process, that’s a big improvement in patient safety. There shouldn’t be any reason why more areas of the hospital can’t start utilizing checklists in the future.

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  • Chuck Brooks

    Pilots of commercial and private aircraft have been using checklists for decades, and there are software products that do checklists for such things as graphic design tasks, semiconductor fab line maintanance and the like. The study led by Dr Atul Gawande should have put this issue to rest for the medical community. Perhaps simple things like this, highly effective as they are, can replace the proposed whiz-bank technostuff bandied about for solving the ‘health crisis’.
    Chuck Brooks
    FutureWare SCG

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