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Nudging doctors in intensive care unit reduces deaths
Date:6/22/2011

CHICAGO --- Caring for patients in a medical intensive care unit in a hospital and flying a 747 are complicated tasks that require tracking thousands of important details, some of which could get overlooked. That's why the pilot has a checklist and a copilot to make sure nothing slips by.

A new Northwestern Medicine study shows the attending physician in the intensive care unit could use a copilot, too. The mortality rate plummeted 50 percent when the attending physician in the intensive care unit had a checklist a fairly new concept in medicine -- and a trusted person prompting him to address issues on the checklist if they were being overlooked. Simply using a checklist alone did not produce an improvement in mortality.

"Attending physicians are good at thinking about big picture issues like respiratory failure or whatever diagnosis brought a patient to the intensive care unit, but some important details are overlooked because it's impossible for one person to remember and deal with all those details," said Curtis Weiss, M.D., the lead investigator and a fellow in pulmonary and critical care medicine at Northwestern University Feinberg School of Medicine.

Weiss conducted the study in the medical intensive care unit at Northwestern Memorial Hospital. The study was published online in the American Journal of Respiratory and Critical Care Medicine and will appear in an upcoming print issue.

"We showed the checklist itself is just a sheet of paper," Weiss said. "It's how doctors interact with it and best implement it that makes it most effective. That's how we came up with prompting."

A checklist is a useful tool only if a physician gets continual reminders to use it to promote decision making, Weiss said, "rather than just being a piece of paper that gets shoved in someone's face like busy work."

For the study, Weiss and colleagues developed a checklist to be used by physicians in the medical intens
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Contact: Marla Paul
Marla-Paul@northwestern.edu
312-503-8928
Northwestern University
Source:Eurekalert

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