The List That Saves Lives

Almost every human being will, by the end of his lifetime, experience a visit to an intensive care unit. In the United States, on any given day, you can find up to 90,000 people in intensive care units. Those staggering numbers demand fine-tuned and precise care from medical care professionals, who are often stressed to breaking point. In more and more hospitals around the country however, a simple checklist is helping deliver such care, saving lives.

The checklist is the brainchild of Dr. Peter Pronovost, and is familiar to Indiana medical malpractice attorneys, doctors and nurses everywhere. Several hospitals around the country have reported substantial success in reducing the number of medical errors made in intensive care units with the use of the checklist. However, for a very long time, it remained impractical to assume that a simple checklist could help reduce medical errors and actually save lives.

In 2001, Dr. Peter Pronovost, a critical care specialist at Johns Hopkins developed a checklist aimed at preventing central line-associated bloodstream infections. The checklist was simple.
• Wash hands with soap • Clean skin with chlorhexidine • Place a sterile drape over patient • Wear sterile mask, gown, and gloves • Place a sterile dressing over the site after a catheter has been inserted
After noting the steps in the checklist up, Pronovost asked nurses to begin monitoring doctors, to see how many of the steps they missed. They found that in the case of more than one third of the patients in the intensive care unit, doctors and nurses missed at least one step.

Pronovost and his colleagues then persuaded the hospital administration to authorize nurses to stop physicians if they were in the process of skipping a step on the checklist. The results were monitored for over a year, and they were staggering. Central line-associated infection rates dropped to zero from 11%. The checklist had saved eight lives, and prevented forty-three infections.

Today, the checklist is an accepted part of hospital protocols around the world. The only thing necessary for the successful use of checklist is a change in hospital safety culture to one that absolutely abhors any kind of medical error, and is willing to put aside the value of hierarchical relationships in order to do so.

According to a report titled To Err Is Human published by the Institute of Medicine, between 44,000 and 98,000 people are killed due to medical errors in hospitals every year. The report confirmed that patient safety was a nationwide problem and that most of these deaths are preventable. In spite of this, there hasn’t been the substantial progress toward patient safety that Indiana medical malpractice lawyers would like to see. This checklist however, offers a ray of hope.