From: ILPI Support <info**At_Symbol_Here**ILPI.COM>
Subject: [DCHAS-L] NYT articles on surgical checklists that helps explain why methanol incidents continue.
Date: Fri, 11 May 2018 13:30:02 -0400
Reply-To: ACS Division of Chemical Health and Safety <DCHAS-L**At_Symbol_Here**PRINCETON.EDU>
Message-ID: 13973030-EBC3-42CF-BE48-0B06D2CA9E12**At_Symbol_Here**ilpi.com
This article from the New York Times explains how surgical checklists can make a significant difference in mortality outcomes: www.nytimes.com/2018/05/09/magazine/surgical-checklists-save-lives-but-once-in-a-while-they-dont-why.html
And yet other implementations elsewhere worked just fine. The article continues:"What happened? How could an idea that worked so effectively in so many situations fail to work in this one? The most likely answer is the simplest: Human behavior changed, but it didn't change enough. Coached attendants washed their hands 35 percent of the time, while the uncoached group, the control group, washed only 0.6 percent of the time. Coached birth attendants measured a newborn's temperature 43 percent of time, compared with participants in the control group, who measured it 0.1 percent of the time. Yet these differences in behavior weren't ample enough to have an impact on maternal or fetal morbidity and mortality."
"In the childbirth trial in India, 35 percent of the attendants started off washing their hands during the first months of the study, while coaching and supervision were still active. By 12 months, when the coaching had ceased, that proportion had dropped to 12 percent.
We might describe this situation as a "behavioral relapse," akin to the physiological relapse of cancer or of an immunological illness. Unlike cancer, though, behavioral relapse has no measure: no marker, no biopsy, no powerful predictive test; it remains undetectable by most methods. As much as we need experimental tools to survey human physiology, doctors need experimental tools to understand, survey and change medicine's least familiar frontier: human behavior."
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