Sunday, 18 January 2009

Surgical Checklist Saves Lives? So does a decent medical training.

The BBC reported this week that a simple checklist has reduced deaths by more than 40% and complications by a third. A lot of us at ND have worked in various surgical specialities and some of us have been anaesthetists at various stages in our careers. We went to the BBC website in search of more enlightenment as to what we were doing wrong all those years ago and the checklist can be found here .

We read it, analysed it and all of us came to the same conclusion. This is exactly what we did when we did surgery and anaesthetics as junior doctors many years ago. The places where this was piloted are Seattle, Toronto, London, Auckland, Amman, New Delhi, Manila and Ifakara, Tanzania.

Given our collective experiences in various locations and theatres is this headline actually telling us something we already know?

That if you have proper training and discipline in all branches of medicine and nursing then you should have good results?

Talk about telling your grandmother how to suck eggs.

Researcher Dr Atul Gawande, from Harvard School of Public Health said:

“The checklist could become as essential in daily medicine as the stethoscope.”

We hope he knows that the correct orifice in which to put a stethoscope if one is using it is in your ears.

Dr Kevin Cleary, NPSA medical director, said:

"The results of the study give clear evidence that a simple intervention leads to dramatic improvement in outcome for patients undergoing surgery."

So does training but that costs and interferes with waiting list initiatives.

Health Minister Lord Darzi, who played a role in developing the checklist, said:

"The beauty of the surgical safety checklist is its simplicity and - as a practising surgeon - I would urge surgical teams across the country to use it.”

That way you won’t remove the wrong organ.

Northern Doc says:

“There is clear evidence that proper training and supervision leads to a dramatic improvement for patients undergoing surgery. Checklists are helpful but they do not replace training. Airline pilots use checklists but the NHS forgets that most airline pilots are also trained but not usually at public expense. You cannot fly an aircraft using a checklist alone experience helps too. Did the pilot who landed the A320 in the Hudson river just do it with a checklist?"

Praise be to the Party for we all know that checklists and protocols are cheaper than training people to do the job right in the first place.


Dr Grumble said...

It seems the pilot did not follow the appropriate check list. There are parallels between what this pilot was landed with and much of what we do.

Anonymous said...

Your comments are interesting - are you saying that the training you received some years ago was 'better' than what juniors receive today?