How ISRO's checklist culture can help cut errors in emergency rooms

Dinesh C Sharma New Delhi | Updated on January 09, 2018

Saving a life in the emergency room of a hospital can be as tough and challenging as launching a rocket. Both situations involve great team effort, quick decision making and precise working of machines. Even the smallest of human or equipment error could be disastrous in both cases.

Now, the Indian Space Research Organisation (ISRO), often praised for its top quality and error-free execution of complex space projects, is going to extend its quality protocols to help emergency and critical care services in Indian hospitals. The space agency has worked with healthcare bodies to develop the first set of quality protocols for emergency and critical care services, drawing from its own quality protocols for space engineering projects.

While medical science has developed a lot, patient care at times suffers due to human and equipment error, particularly in emergency and critical care set-ups. Doctors are under stress as they are often racing against time. Lives can be saved if these errors can be minimised by the adoption of quality protocols.

“When I discussed this with Dr K Kasturirangan, former Chairman of ISRO, a few years ago he said the intensive and emergency care unit is like a space vehicle launch site where there can be no room for error. This led to the idea of adapting some of the appropriate best practices of ISRO into healthcare setups,” Dr Alexander Thomas, President of Association of Healthcare Providers-India (AHPI), told India Science Wire.

Further discussions led to the identification of two high mortality areas – emergency medicine and critical care medicine – for adapting best quality practices. Experts from the Society for Emergency Medicine-India and the Indian Society for Critical Care Medicine, Quality Council of India, as well as Planet Aerospace collaborated with ISRO to develop the two quality manuals. The documents were released at the National Health Conclave in New Delhi recently.

While there is a difference in the working of engineering projects and a medical emergency, quality procedures from one sector can be adapted by the other. The ISRO practices, which have been adapted for critical care include making quality an integral component of critical care; minimum standards and periodic critical review of intensive care unit design; ensuring quality certification and calibration of all equipment; quantitative and qualitative performance assessment of all staff deployed for intensive care; periodic co-performance audits to ensure adherence to checklists; and evaluation benchmarked on Key Performance Indicators.

“Checklists ensure that errors are minimised and every aspect of a particular procedure is executed while protocols ensure that minimum standards of a particular modality are uniformly followed,” the guidelines explain. Since communication gaps are one of the major reasons for error in intensive care units, it has been suggested that a communication checklist be maintained for each patient and signed by doctors. These sheets should also cover communication with patient relatives and communication during shift handovers.

Dr Thomas said the quality guidelines would be disseminated in the medical community but their adoption would depend on individual hospitals as the guidelines were voluntary in nature.

(India Science Wire)

Twitter handle: @dineshcsharma

Published on October 31, 2017

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