Thursday, October 02, 2014

Paging Dr. Gawande

The patient first arrived at Texas Health Presbyterian Hospital in Dallas late on Sept. 25, complaining of a fever and abdominal pains, hospital officials said at a news conference. A nurse administered a checklist, on which the patient indicated that he had recently traveled from Liberia. Nevertheless, the hospital sent him home.

-from Time Magazine's "Mistake Led to Ebola Patient's Initial Release" post last evening.

Dr. Mark Lester, Southeast Zone clinical leader for Texas Health Resources, said a checklist for screening for Ebola was in place when the patient entered to [sic] the hospital on September 26, and that he was asked about his recent travels, including to Liberia, where the disease has killed nearly 2,000, according to the CDC. “Regretfully [sic], that information was not fully communicated” to the rest of the patient’s care team, Lester said. Lester described the patient’s condition as “serious but stable.”

-from a Newsweek post on October 1.

This is a nightmare right out of Arul Gawande's, The Checklist Manifesto: How to Get Things Right.  While Dr. Gawande does not write specifically about the virus, it is clear that the Emergency Department at Texas Health Presbyterian Hospital lacked the teamwork and discipline that make the simplest of checklists effective, the very things Dr. Gawande emphasizes in his excellent book.

(The New Yorker has just published an article by Dr. Gawande, "The Ebola Epidemic is Stoppable.")

No comments: