Lean Healthcare Follow-up to "The Checklist" by Atul Gawande

If you didn't see this article check it out here....this is standard work 101 in healthcare, with phenomenal results:

http://www.newyorker.com/reporting/2007/12/10/071210fa_fact_gawande

Here is the extremely dissappointing conclusion of this pioneering work in healthcare process improvment:

http://www.nytimes.com/2007/12/30/opinion/30gawande.html?scp=11&sq=atul+gawande&st=nyt

Please note the following emphasis (mine) from Gawande's op-ed piece:

"this past month, the Office for Human Research Protections shut the program down.," Gawande writes. "The agency issued notice to the researchers and the Michigan Health and Hospital Association that, by introducing a checklist and tracking the results without written, informed consent from each patient and health-care provider, they had violated scientific ethics regulations. Johns Hopkins had to halt not only the program in Michigan but also its plans to extend it to hospitals in New Jersey and Rhode Island.

'The government’s decision was bizarre and dangerous,' Gawande adds. 'But there was a certain blinkered logic to it, which went like this: A checklist is an alteration in medical care no less than an experimental drug is. Studying an experimental drug in people without federal monitoring and explicit written permission from each patient is unethical and illegal. Therefore it is no less unethical and illegal to do the same with a checklist. Indeed, a checklist may require even more stringent oversight, the administration ruled, because the data gathered in testing it could put not only the patients but also the doctors at risk — by exposing how poorly some of them follow basic infection-prevention procedures.'"

Blinkered logic, indeed. I think the government has a tail-light burnt out.