Re:Surgeon Atul Gawande selected as CEO of new health care c...
by arkades on Wednesday June 20, 2018 @07:49PM
(#17360944)
> but if you come up with the right checklist and get the right buy-in, you do see fewer complications.
Bingo.
What the state of the research shows is that you have an active QI-focused culture and buy-in, checklists work over the medium long term, but not better than anything else. If you don’t have those things, the checklists do nothing after 3-6 months (a lot of studies hide this by rolling up the study period, but everyone in the field knows how rapidly the effect decays). I haven’t seen any meaningful data on them >2 years out, but let’s let that slide, out of pragmatism.
What that suggests is that checklists are irrelevant to this discussion. It’s just a lot harder to sell something as vague and nebulous as “creating a safety-focused and quality-driven culture” than it is to sell “checklists!”.
I just thumbed through meta-analyses on Google scholar and this definitely doesn't look like the results of recent research into checklists (e.g. https://onlinelibrary.wiley.com/doi/full/10.1002/bjs.9381)
It seems like there are problems getting people to agree to do checklists or keep with them, but if you come up with the right checklist and get the right buy-in, you do see fewer complications.
(If anyone wants to look at the recent research for themselves, here's the Google Scholar search I used: https://scholar.google.ca/scholar?as_ylo=2014&q=checklist+su...)