Saving lives 101

 
Interactive check list for severe malaria

Interactive check list for severe malaria

1. Checklists for severe malaria

In 2011, the Liberian Ministry of Health asked for support at its public hospitals for the country's first use of IV Artesunate, a medicine that was found to decrease death from malaria by 30% relative to IV quinine. Quinine had been used in Liberia for over forty years.

To make a long story short, we created a checklist for the proper diagnosis and treatment of IV Artesunate and were able to change health staff practice to the new protocol-- in two weeks. Of course we oversaw the process, but many months later, doctors and nurses were still using the checklist because it was easy and made sense. Read the study 

 

Feeding a three pound baby from a checklist in Medan as part of the normal nurse routine

Feeding a three pound baby from a checklist in Medan as part of the normal nurse routine

2. Checklists for feeding sick infants

Checklists for critical interventions saves lives. For example, if you don't feed babies, they die. In a study of six public hospitals across Indonesia, we constructed a dynamic checklist that helped doctors and nurses calculate how much milk to give sick and premature babies over time. This was not intuitive because sick and premature babies don't suck sufficiently.  

One key lesson for this intervention was in the area of task shifting. Usually a pediatrician determines how much hospitalized infants are to be fed. But pediatricians are rare in most places and therefore frequently not present during feeding time. Could general doctors and nurses learn a task traditionally taught only to the specialist? The answer was yes - for most anything really.

 

A picture of a medical record's room kind of says it all

A picture of a medical record's room kind of says it all

3.  Find the health record, then read it

In most medical facilities in the world, thousands of charts hide essential patient information - a patient's allergies, the medicines a patient takes, current diseases and conditions.  Not acting on important and previously recorded medical information is called an error of omission. Acting on a person which is harmful because you don't know something you should is called an error of commission.

Whatever the type of error, medical errors from disorganized or absent medical charts kill tens of thousands of patients every day. That’s why Walking Doctor's first literal and figurative step with clients is to organize patient data onto the computer. It’s the first essential step of many. Read more…