Nepali Times
Life Times
The Checklist

DHANVANTARI by BUDDHA BASNYAT, MD


To avoid medical mishaps, it seems a checklist is still the best thing to do. If you are seated in front of an aircraft and can see the pilots in the cockpit, you will have noticed that they have a set of things to do which they read to each other from a checklist before they takeoff. It seems a similar checklist could help doctors better treat patients.

For the mundane task of washing hands, wearing gloves, to prevention of bedsores in patients, there is a checklist that doctors and nurses now have to follow in many hospitals. For some in the health profession this tends to be boring and unnecessary.

The person who highlighted the importance of the checklist in medicine is a Harvard surgeon and writer, Atul Gawande. His parents, also doctors, are Indian immigrants and Gawande very cogently states that four generations after the first aviation checklist went into use, checklists are now finally used in medicine to catch mental flaws inherent in all of us: lack of memory, thoroughness and attention. He thinks checklists provide a kind of cognitive net. And now there are even studies to back all this up.

For many people the humble checklist runs counter to our thoughts about what professionals should do. Are they so forgetful that they have to look at a checklist if they are wearing a mask for a minor procedure? The truly great are supposed to be daring with no protocol to follow. Gawande thinks that our ideas need updating, and recalls the miraculous survival of all on board a US airliner that crashed into the Hudson River in January 2009 after flying into a flock of geese on takeoff.

The journalists who covered the story were clearly disappointed because rather than talk about the amazing landing with romantic overtones, the captain of the plane emphasised the checklist that he followed that saved the lives of the passengers.

In the world of surgery, checklists can be especially very relevant. Gawande devised a 90-second checklist that reduced deaths and complications by more than one-third in eight hospitals around the world, at essentially no extra cost and for almost any kind of operation. All of this seems too good to be true, and yet the facts speak for themselves. Checklists are clearly relevant for Nepal as well.



LATEST ISSUE
638
(11 JAN 2013 - 17 JAN 2013)


ADVERTISEMENT



himalkhabar.com            

NEPALI TIMES IS A PUBLICATION OF HIMALMEDIA PRIVATE LIMITED | ABOUT US | ADVERTISE | SUBSCRIPTION | PRIVACY POLICY | TERMS OF USE | CONTACT