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Fewer surgical complications? Check. And sign us up.

Posted by Ishani Ganguli  January 14, 2009 05:21 PM
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Short White Coat is a blog about learning to be a doctor. Posts appear here as part of White Coat Notes. Ishani Ganguli is a third-year Harvard medical student. E-mail her at shortwhitecoat@gmail.com.
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A Harvard School of Public Health study showing that a basic surgical safety checklist -- akin to those used by pilots before take-off -- may sharply reduce the rate of deaths and complications in the operating room by more than a third got me thinking about the medical student's role in patient safety.

A pared-down version of this concept is already used nationwide in the pre-operative “Time Out,” in which a member of the hospital team verbally verifies that the right patient is getting the right procedure in the right location. In the Brigham and Women's Hospital OR, the surgical tech runs through the questions with a cheerful reluctance, as if to reassure the sleeping patient that of course we know you’re Mary Smith with the left ovarian cyst that needs removing.

I have never observed a near or actual slip in my brief experience. But they do occur. And as these new numbers demonstrate, simple steps can make a huge difference when extended globally.

As medical students, we stand on the sidelines all too often when it comes to policing imperfections in health care delivery. Yet those of us with the least experience can be the keenest observers of process. I asked Dr. Atul Gawande, senior author of the study and a Brigham surgeon, what role he sees for students in this particular initiative.

For one thing, he noted, the checklist explicitly asks all members of the OR team to participate vocally in attending to the patient’s safety. Also, he wrote in an e-mail, "a similar approach could markedly improve results in emergency care, labor and delivery, and many other segments of medical care. And I think it's the new generation of doctors that are going to be the pioneers in making these kinds of successful systems innovations a reality."

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About white coat notes

White Coat Notes covers the latest from the health care industry, hospitals, doctors offices, labs, insurers, and the corridors of government. Chelsea Conaboy previously covered health care for The Philadelphia Inquirer. Write her at cconaboy@boston.com. Follow her on Twitter: @cconaboy.
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