Science-- there's something for everyone

Thursday, February 10, 2011

To prevent infection, use a checklist

Among the dangers associated with being seriously ill is the very real possibility of developing an additional infection in the hospital. In particular, an estimated 80,000 patients a year get infections from their central lines (plastic catheters placed into veins to administer drugs or fluids). To avoid these infections, Peter Provonost of Johns Hopkins University suggests that doctors use a checklist.

Provonost literally wrote the book on using medical checklists: Safe Patients, Smart Hospitals: How One Doctor's Checklist Can Help Us Change Health Care from the Inside Out. Based on his recommendations, Michigan hospitals began a five year long study called Keystone: ICU, in which doctors were asked to consult checklists before each procedure, and junior caregivers were given authority to question their superiors at any point. These seemingly simple steps resulted in a significant decrease in hospital mortality. At Johns Hopkins itself, central-line bloodstream infections dropped to nearly zero after implementation of Provonost’s protocols.

The idea of using medical checklists is gaining momentum. At first, some medical health professionals bristled at the idea that they needed to consult a checklist to remember to wash their hands or put on gloves. However, the data that show the benefits of following these procedures is compelling. Hospitals across the country are beginning to use this methodology with great success.