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SALT LAKE CITY -- A top doctor is advocating that more hospitals and doctors use checklists in complex surgical procedures.
Dr. Atul Gawande, a Harvard Medical School teacher and longtime advocate of surgical checklists, is making the case in a new book, "The Checklist Manifesto."
Gawande helped develop a checklist system for the World Health Organization. But the idea, though it's been around for some time, is not as universal as some may think. USA Today reports only about 20 percent of hospitals are using the list.
The University of Utah's chief medical officer, Dr. Tom Miller, says their surgeons use the list, with some minor modifications, in the operating rooms.
"When you have multiple and coordinated actions, these are pretty much, I think, doomed to failure if they're left to each participant's memory," he says. "I think memory is fallible."
...The steps that are required need to be automatic, or they're going to fail along the way,
–Dr. Tom Miller
He says the safety of patients requires some protocol. "You either have to be very, very experienced and the steps that are required need to be automatic, or they're going to fail along the way," Miller says.
Miller says those failures could include mistakes that lead to infections, wrong-site surgeries or objects left in a patient's body following surgery. Still, he says, some doctors are somewhat suspicious of checklists and protocols.
"We're trained to be critical thinkers," he says. Doctors are also trained to treat a patient as an individual, and that one size does not fit all. Miller says that may be an issue when it comes to diagnoses and therapies, but not when it comes to going into an operating room and performing perfect techniques.
He believes in time, most in medicine will buy into the idea that he calls "an important step" into providing excellent care.
E-mail: mgiauque@ksl.com
