A checklist provides a frame work and initiates brief discussion about the case, expected difficulties and plan of action to deal with complication or difficult situations.
In the previous article, we discussed about human factors as one of the most important reasons for errors. An individual is aware of his/her immediate surroundings but not about the larger surroundings. This is called as “situational awareness”.
A person may do his/her job diligently, but when it comes to synchronous activity of different departments or different persons there is always a potential for error. When two people with different background information start functioning together, there is bound to be a gap. When few actions, having no logical sequence, have to be done in synchronized manners, the chance of something getting missed is high. Think of a memory test where few different objects are flashed in front of you and you are asked to memories them. It is a high possibility that you may forget some of them, if not, you will not recollect them in the same order!
When checklists come into play
Checklists find their way in such situations. Actually checklist is not a new concept at all. Do we not make a “To Do list”? However, the institutionalization of the checklist has an interesting history. In 1935, U.S. Military had organized an exhibition cum-competition for aircraft manufacturers. Boeing, the famous aircraft manufacturer was also in the competition. Model 299 of Boeing was very advanced and could carry five times more bombs than expected by the US military. The competition was a mere formality by Boeing. Major Hill, a very experienced pilot and trainer was given the job to fly the aircraft on that day. Model 299 took off smartly. The aircraft reached the height of around 300 feet height and suddenly tilted to one side. Within few seconds it collapsed to the ground and caught fire. Major Hill lost his life. After this unexpected accident, a fact finding committee was constituted. The committee concluded that there was no technical fault in the aircraft. The pilot was at fault! How could an experienced pilot commit such a blunder? That took a blunder that could cost his own life? Later, it was realized that the systems of the aircraft were quite complicated. Actually, the pilot was supposed to perform a number of tasks within a small period of time in a synchronous manner. And Major Hill had simply forgotten to perform one out of them! Continue reading
आसन्नमरण स्थितीत ४२ वर्षे जगलेल्या अरूणा शानबाग यांचे देहावसान झाले आणि ‘इच्छामरण-दयामरण’ हा विषय पुन्हा एकदा चर्चेत आला. माणसाला सन्मानाने जगण्याचा जसा हक्क आहे तसाच सन्मानाने मरण्याचाही हक्क हवा, असे म्हणणाऱ्यांची संख्या वाढते आहे, पण या हक्काकडे संशयाने बघणाऱ्यांच्या शंकांचेही निरसन झालेले नाही…
The new Medical Termination of Pregnancy (Amendment) draft bill says abortions can be performed not only by allopathic doctors but by Ayurvedas, homoeopaths and midwives as well.
Today’s medicine is like a double edged sword, it can benefit but also harm
Richie Williams was young boy of 12. He was suffering from leukemia (blood cancer) and was undergoing treatment at the Great Ormand Street Children’s Hospital which specialised in treating such patients. Richie used to receive anti-cancer medicines in a cyclical manner. He used to go to the hospital on a pre-scheduled day to receive his dose of chemotherapy. They used to give him a dose of injection Vincristine by intravenous route. Another dose of injection methotrexate would be injected intra-thecally (injection between the spaces in the back bone, typically called as spinal injection). Being young, Richie used to get a small dose of sedative first and then the spinal injection would be given to him. He was doing well and recovering fast. In fact, he was almost at the end of the chemotherapy regime.
आपल्या देशात आयुर्वेदासारख्या शास्त्राची जोड आधुनिक वैद्यकाला देऊन एक परिपूर्ण अशी आरोग्यव्यवस्था बनवायला हवी होती, पण झाले उलटेच! अजूनही ‘डॉक्टर कमी आहेत’ अशी बोंबाबोंब करून, नवीन वैद्यकीय महाविद्यालये उघडून देणग्या घेऊन डॉक्टर बनवण्यापेक्षा असलेल्या आयुर्वेदिक, होमियोपथिक डॉक्टरांना थोडेसे शिक्षण देऊन त्यांच्यातून अधिक परिपूर्ण जीपी किंवा फॅमिली डॉक्टर आपण बनवू शकतो. यूकेने त्यांच्याकडील डॉक्टरांच्या कमतरतेवर तोडगा काढलाय. त्यांनी त्यांच्या देशातील नस्रेसना विशेष प्रशिक्षण देऊन त्यांना एका ठरावीक परिघात आणि डॉक्टरांच्या देखरेखीखाली जी.पी.सारखे काम करण्याचा अधिकार दिला आहे. आणि आपण मात्र डॉक्टरांची जातीव्यवस्था बनवून स्वत:च्याच पायावर धोंडा मारून बसलो आहोत.. 
A message that goes in rounds on social networking sites reads as under:
To make prescribing medicines a patient-friendly experience, leading gynecologist and founder of NGO-Patient Safety Alliance (PSA), Dr Nikhil Datar, has come up with an app named ‘Safe Rx’ that will be launched soon.
रुग्णालयात बलात्काराची केस आली की त्यात डॉक्टर, पोलीस यंत्रणा आणि नंतर न्यायव्यवस्था सहभागी होत असते. अशा वेळी अशी केस गुन्हेगारी प्रकरण म्हणून हाताळावी का? त्यासाठी सर्वच रुग्णालयांत एकसारखी व्यवस्था आहे का? या संदर्भातली नेमकी प्रक्रिया काय, या विचारमंथनातून तयार झाला तो एक सम्यक प्रोटोकॉल, एक सम्यक प्रयोग, बलात्काराच्या सर्व प्रकरणांमध्ये लागू पडणारा. ज्यामध्ये पीडित महिलेला तपासण्यापासून, उपायांपासून, समुपदेशनापर्यंत बाबींचा अंतर्भाव होता. केंद्रीय आरोग्य मंत्रालयाने नुकत्याच आयोजित केलेल्या ‘बलात्कार आणि आरोग्यव्यवस्थेचा सुयोग्य प्रतिसाद’ या चर्चासत्राच्या निमित्ताने.