Word: checklists
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Dates: during 2000-2009
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...checklist is kind of an effort to produce a consistent Hawthorne effect," says Gawande. "It is intended to make people aware that other people expect these things to be done." Researchers checked whether teams behaved differently when the researchers were present and when they were not and found no difference...
...result of the findings, Gawande says, the U.K.'s National Health Service sent an alert to all of its hospitals, calling on them to use the surgical checklist. Five U.S. states - New York, Washington, North Carolina, South Carolina and Indiana - have endorsed it and plan to require hospitals...
However, in one case where he was preparing to remove an adrenal tumor, the anesthesiologist realized during the checklist rundown that extra blood might be required but was not on hand. The blood was delivered to the OR - and the patient did need it during surgery. "I'm convinced that the fact that the anesthesiologist caught that was what saved this man's life," Gawande says, adding that his team averts at least one potential problem via the checklist every week...
Whether these changes can be sustained over time is another question. Gawande and his colleagues note in the study that a phenomenon called the "Hawthorne effect" may be largely responsible for the checklist's success. The effect was named for a series of experiments designed to determine how to increase productivity at a factory in Chicago. All of the tactics implemented by the study leaders improved worker output during the experiments - but researchers realized that the effect they were really measuring was a boost in motivation among workers who knew others were watching...
...federal Office for Human Research Protections (OHRP) did not approve. After Pronovost was profiled in the New Yorker by Gawande in 2007, OHRP shut down data collection for the checklist study, claiming that it amounted to research being done without patients' informed consent. But the ensuing media attention spurred Congress to intervene, and Pronovost's program was allowed to continue and expand...