Gawande on Cowboys and Pit Crews
Although hospitals have introduced technology to cut down on mortality, the death rate from surgery has remained high. About 150,000 deaths a year are attributed to surgical complications, but about half are avoidable, Gawande says.
Part of the frustration stems from the fact that although checklists in surgical situations have been proven to reduce complications and costs, hospitals, health systems and physicians, with many notable exceptions, continue to resist them.
"I spend half my time as a surgeon building checklists," he says. "Many industries that grapple with high risk and high failure depend on them, like skyscraper construction or airlines." Boeing, whose top safety engineer is helping on this project, says a good checklist undergoes as many as 50 revisions before it is incorporated into practice.
ACCESS. INSIGHT. ANALYSIS.
Join the HealthLeaders Media Council
Get members-only access to industry-wide intelligence, forecasts, and analysis positions your organization to benchmark against your peers, identify and respond to key trends shaping healthcare, and make sound business decisions.
"Through use of this successful two-minute checklist, patients had a 47% lower death rate and complications dropped by one third," he says. "VHA has tried it across 74 hospitals; results show an 80% drop in mortality."
"If we had a drug that could cut complications by this much, everyone would implement it, we would have ads all over TV, and lots of people would become rich from it. But it's free, and ironically, that's part of the problem," he said. "Contained in checklists are values very different from what we have in many cases. It requires humility, discipline, and teamwork."
- Governors Push to Expand Role of PAs, Telemedicine
- 3 More Pioneer ACOs Say They Will Quit
- Ebola in the U.S.: Reason to Fear, to Hope, to Prepare
- Why Open Payments Irks Physicians
- Top Provider Billing Mistakes Are Changing
- Difficult Patients: It's Not Them, It's You, Doctor
- Overcoming a Payer Mix 'Nightmare'
- Employee Engagement: Make It Meaningful
- These Algorithms Reduce Readmissions
- Payer Calls for More Primary Care Docs, Team Care