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Surgery Checklists Help OR Teams in a Crisis, Study Finds
Date:1/17/2013

By Mary Brophy Marcus
HealthDay Reporter

WEDNESDAY, Jan. 16 (HealthDay News) -- Perhaps you've seen the nail-biter episodes of "Grey's Anatomy" or another medical drama: One moment a surgery is progressing smoothly and the next, a patient's heart stops beating or he begins bleeding uncontrollably, and havoc breaks out in the operating room.

It happens in real life, too, said Dr. Atul Gawande, author of a new study that shows that if surgical teams follow a checklist when crises hit, important life-saving steps are less likely to be skipped.

"We've always believed you stay away from checklists and algorithms for these, that surgery is complicated and takes judgment and seat-of-the-pants thinking," Gawande said. "But when we tested surgical teams with crisis checklists, having a playbook proved majorly beneficial."

Gawande, a surgeon at Brigham and Women's Hospital in Boston and a professor in the department of health policy and management at Harvard School of Public Health, said that although it's rare for an individual doctor or nurse to experience an operating room crisis, such events are not uncommon for large hospitals. A hospital with 10,000 operations a year logs an estimated 145 such surgical emergencies annually, according to the study, which was published in the Jan. 17 issue of the New England Journal of Medicine.

"The major problem is a failure to rescue people when something goes wrong," Gawande said.

"Serious complications, such as when the patient stops breathing, the heart stops, blood pressure changes, massive bleeding -- when things hit the fan, it's total chaos. It's incredibly stressful," he said. "But it doesn't happen every day for someone handling it, so you're calling on skills that have been laying dormant."

Gawande conducted research four years ago that shows using pre-surgery checklists cuts down on complications during a procedure, but he and his colleagues wa
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