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H&HN Daily

10 Simple Questions to Save a Life

06.27.13 by Matthew Weinstock H&HN Assistant Managing Editor

A new HRET guide expands the use of checklists to reduce patient harm.

It seems so simple. Create a list. Ask 10 basic questions. Check the boxes. Begin the procedure.

So simple, yet, as with everything in health care, so unnecessarily complicated.

The history of checklists in health care is well-documented. Advocated by the likes of Peter Pronovost, M.D., Atul Gawande, M.D., and the WHO, checklists have been utilized around the globe to reduce complications during surgery and improve patient safety. Now, the Health Research & Educational Trust is taking it a step further by developing a checklist guide that can be used to help prevent adverse drug events, injuries from falls, pressure ulcers and more.

Released today, "Checklists to Improve Patient Safety" homes in on 10 areas of patient harm that are being targeted by the federal government's Hospital Engagement Network initiative, which aims to reduce patient harm by 40 percent and readmissions by 20 percent over a two-year period. With nearly 1,500 hospitals and 31 state hospital associations participating, HRET operates the nation's largest HEN (be sure to see our special report on HRET HEN).

The checklists record whether a process is in place, was not done or will be adopted. It also notes who is responsible for the process and when it was/will be completed. The adverse drug event list touches on such things as, "Identify look-alike, sound-alike medications and create mechanism to reduce errors." And, "coordinate meal and insulin times."

Again, simplicity.

The expansion of checklists doesn't stop with these 10 HEN focus areas. Gawande, HRET, AHRQ and others are bringing the concept to ambulatory surgery centers. As an increasing amount of health care is delivered in outpatient settings, it stands to reason that many of the initiatives aimed at improving quality and safety in hospitals also would make the migration. AHRQ's Safety Program for Ambulatory Surgery seeks to test the effectiveness of surgical checklists and other safety processes in outpatient settings.

"We do 50 million operations a year on a population of 300 million people. Fifteen million or so are done in the hospital, but 35 million, and potentially more, are done in outpatient surgery," Gawande said in a March 14 webinar kicking off the initiative. He suggested that bringing checklists to surgery centers could prevent emergency department visits and hospital admissions down the road.

Be on the lookout for an exclusive interview with Gawande on this topic early next month in H&HN Daily.

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The opinions expressed by authors do not necessarily reflect the policy of Health Forum Inc. or the American Hospital Association