So simple

Using airplane-type checklists in medicine seems to have many benefits.

It’s so simple and practical, but it’s been ignored far too long — to the detriment of people receiving medical treatment.

We’re talking about a checklist for physicians, surgeons and their aides, much like the lists that airplane pilots have been using for decades to “prep” their equipment for takeoffs and landings.

Atul Ganwande, a surgeon who teaches at the Harvard Medical School, notes that medicine today is so complex that even the brightest and sharpest no longer can keep everything they know, or need to know, “in their heads” for immediate recall. The result, says the highly regarded Ganwande, is that patients do not always get the care they need because “something gets left out or forgotten.”

In a USA Today article, Ganwande estimates that only about half of heart attack patients get the best care within the recommended time window. In some cases, providing consistent care can be more important than a new breakthrough. And even after a new discovery, research shows it takes an average of 17 years for that treatment to reach even half of the Americans who could benefit.

“We have focused on having the great doctor or the great drug,” says Gawande in his new book, “The Checklist Manifesto.”

“But on your own, with your training and your brain, there will be things that fall through the cracks, where you find you need the help of other people,” he adds.

That help, he emphasizes, can come from a simple checklist. In a study published last year, there was data that a “safe-surgery checklist,” which Gawande helped develop for the World Health Organization, reduced the number of complications and deaths by more than one-third.

The checklist requires surgical teams to pause at all three crucial points before and after surgery asking such questions as: Is there enough blood on hand in case of severe bleeding? Have proper antibiotics been administered? What are the anesthesiologist’s and nurse’s main concerns?

Going over a checklist, which takes about two minutes, says Gawande, “can get the dumb stuff out of the way” and allow the team to focus on the most demanding tasks. Gawande has personal examples of how checklists have saved lives or prevented bad medical actions.

More and more, hospitals are making sure to identify patients, where their surgery needs to be performed and what steps are in their best interests. We all have heard horror stories about medical treatments that have been slapdash, improper and inefficient and there is a good deal of evidence that valid checklists could have eliminated sponges left in wounds, operations on the wrong leg or arm and other terrible errors.

If simple checklists can eliminate many of those problems, hospitals and medical personnel shouldn’t hesitate to make them part of their standard operating procedure.