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airborne_artist
15th Jan 2009, 09:03
BBC NEWS | Health | Surgical checklist 'saves lives' (http://news.bbc.co.uk/1/hi/health/7825780.stm)

Using a simple surgical checklist during major operations can cut deaths by more than 40% and complications by more than a third, research has shown.
The National Patient Safety Agency (NPSA) has ordered all hospitals in England and Wales to use it across the board by February 2010.

The checklist, devised by the World Health Organization (WHO), was tested in eight cities around the globe.

Staggering to think that it's taken the world of medicine this long to work this one out.

"Health Minister Lord Darzi, who played a role in developing the checklist, said: "The beauty of the surgical safety checklist is its simplicity and - as a practising surgeon - I would urge surgical teams across the country to use it. "Operating theatres are high-risk environments.

By using the checklist for every operation we are improving team communication, saving lives and helping ensure the highest standard of care for our patients.

The amazing results from the global pilot puts this beyond any doubt."

It ain't rocket science, you know. There's even a passing reference in there to CRM.

Any aviating medics care to comment?

gingernut
15th Jan 2009, 12:13
I think he's asleep- its snoozy time in South Africa.

But I must ask, is rocket science that complicated? You've only gotta get the thing into orbit havn't you?

airborne_artist
15th Jan 2009, 13:30
You've only gotta get the thing into orbit havn't you?

But if it's manned you have to get them back, too ;)

BombayDuck
15th Jan 2009, 13:59
You mean they were doing it all this time without a checklist?! :eek:

Dr747
16th Jan 2009, 19:03
You mean they were doing it all this time without a checklist?!
Oh no no no no... we do have lists here in this country infact they are more than few pages long(which is a good thing;)). infact this new list wont even be a summary of those forms.
there are lists for equipment check( both for before and after the surgery) and they still forget something inside!!!
Pt and surgery check ( and they still chop off or take out the wrong thing)

And offcourse the verbal list of the consultant's song CDs(depending on his age it can be very painful procedure to try to like his music)

I think the most important thing to check is that the surgeon has done that surgery ATLEAST once with someone else!!!

Loose rivets
16th Jan 2009, 19:22
Funny that. We sometimes have to read checklists while the office is shaking about, so I guess that reading them with bloody fingermarks all over them is a similar challenge.:}

Don't know what triggered this memory, but...

Many, many moos ago, there was a surgeon. He was very good at his job, and everyone treated him like a god. Sadly, he slowly succumbed to what might well have been Alzheimer's. At first, just a few things went wrong, nothing unusual for this era, but soon he was making radical incisions where before he taught conservative intrusions into the flesh. Many patients died, but he was so respected, that all that observed him thought there must have been good reason for what he was doing. It took a long time for someone brave enough to pipe up. From a book called something like History of Surgery. I read it while I was supposed to be studying airy-planes.

Howard Hughes
16th Jan 2009, 19:31
The other area where medicine is becoming more akin to aviation is CRM! Many surgeons are adopting CRM techniques for use in operating theatres, encouraging all to speak up if they see something wrong and not just accept what is going on because the surgeon is the 'Chief of Staff'.:ok:

The bit I don't get about medicine is how people who have been awake for 36 hours are allowed to treat patients!:eek:

gingernut
16th Jan 2009, 20:50
Ok, I take it back, having just took the kids to the National Media Museum in Bradford (great day out by the way), and watching a documentary about the International Space Station in their 3D cinema, Rocket Science does look a bit complicated.

(Although does Rocket Science include getting the astronauts back?-getting them into orbit did look pretty much straightforward.)

One thing did stick out though-how bloomin untidy and awkward the ISS is. From the outside, looked like someone on drugs had designed it with Lego.

From the inside, couldn't help thinking that it was equally untidy-lots of loose wires and stuff-looked like the inside of my first car-the Escort Mark II, when I tried to install an 8-track and my music centre speakers.

Should surgeons use checklists? I guess they already do, even if it's only mentally.

I'll have to take a closer look at the report in detail before I offer an opinion- I'd have to be convinced that this added intervention saves lives.

Whiskey Kilo Wanderer
16th Jan 2009, 21:29
I seem to recall a recent piece on the radio about an airline pilot whose wife had died as a result of a ‘simple’ operation that had gone wrong.

There were CRM type issues in the operating theatre, but what really got to the pilot was that they don’t investigate a problem in the operating theatre unless someone complains.

The pilot complained and the resulting investigation found what we would recognise as CRM type problems (Surgeon fixated on one problem, not listening to a theatre nurse who’d spotted another potentially more serious problem).

The pilot started a charity to introduce aviation ideas, CRM, incident investigation, CHIRP etc. to the medical world. I wondered if this is a spin-off from the pilot’s efforts.

gingernut
16th Jan 2009, 21:46
Does CRM work in the aviation world? Or do you just pay lip service?

Not a wind up question, just wondered how it works in practice, and how this can be translated to the health service.

Does your culture really allow for the person at the bottom of the hierarchy, to question the person near the top?

Say again s l o w l y
17th Jan 2009, 00:33
Not always, but usually yes.

One of our instructors was a vascular surgeon and often remarked how he thought the surgical world would benefit from using aviation practices, especially when it came to annual checks and procedures.

I've often noticed this year how the medical and flying professions are actually similar in more ways than you'd imagine.

Howard Hughes
17th Jan 2009, 01:14
Does CRM work in the aviation world? Or do you just pay lip service?

Not a wind up question, just wondered how it works in practice, and how this can be translated to the health service.

Does your culture really allow for the person at the bottom of the hierarchy, to question the person near the top?
You raise some very pertinent points Ginge, for CRM to be trule effective it needs to be fully supported by all, in particular from the top down.

While the major airlines spend millions each year on equipping their staff with the necessary training, I have heard considerable anecdotal evidence that some Captains still believe in the "my way of the highway' approach to operating an aircraft. CRM is not intended to undermine ones authority as Commander, but to enhance it by providing additional (possibly overlooked) information. I can site numerous examples where an additional pair of eyes has saved the day, I can even provide examples where untrained eyes have contributed to saving lives!:eek: