Here's the operative sentence: "a year after surgical teams at eight hospitals adopted a 19-item checklist, the average patient death rate fell more than 40 percent and the rate of complications fell by about a third, the researchers reported."Hospitals are dangerous. Surgery is dangerous. Modern medicine saves many more people than it kills, but it kills many more people than you'd think. The Institute of Medicine estimates that 100,000 Americans die every year from medical errors. That's 35 9/11s every year. There's much talk over the flood of medical malpractice lawsuits but rather less about the flood of medical malpractice. But it is a crisis, and unlike the legal proceedings, thousands die from it. It's also needless. The results of the checklist (pictured above -- click for full-size) are encouraging, but also startling. 19 questions -- questions as simple as whether the patient's identity confirmed been confirmed and his surgery site marked -- dropped the death rate by 40 percent and the complication rate by a third. That means not only that more people lived, but there was less need for follow-up care, for rehabilitation, for corrective surgeries. It's possible that some of that improvement came because the surgery teams knew they were being studied but that simply underscores the point: More attentiveness means fewer deaths. One of the secrets of health reform is that there's substantial opportunity within the system to make it cheaper while making it better. Instead, the discussion proceeds as if we were facing a tradeoff in which every dollar saved is a dollar of health lost. We're not. A system where all the records are written on paper and tucked in manila envelopes, where surgical deaths drop by 40 percent with the addition of a 19-item questionnaire, where prescriptions are scrawled on scraps of notepad, and where there's little in the way of independent evidence demonstrating cost-effectiveness is not a system that lacks for expensive inefficiencies. THE CHECKLIST.
Here's the operative sentence: "a year after surgical teams at eight hospitals adopted a 19-item checklist, the average patient death rate fell more than 40 percent and the rate of complications fell by about a third, the researchers reported."Hospitals are dangerous. Surgery is dangerous. Modern medicine saves many more people than it kills, but it kills many more people than you'd think. The Institute of Medicine estimates that 100,000 Americans die every year from medical errors. That's 35 9/11s every year. There's much talk over the flood of medical malpractice lawsuits but rather less about the flood of medical malpractice. But it is a crisis, and unlike the legal proceedings, thousands die from it. It's also needless. The results of the checklist (pictured above -- click for full-size) are encouraging, but also startling. 19 questions -- questions as simple as whether the patient's identity confirmed been confirmed and his surgery site marked -- dropped the death rate by 40 percent and the complication rate by a third. That means not only that more people lived, but there was less need for follow-up care, for rehabilitation, for corrective surgeries. It's possible that some of that improvement came because the surgery teams knew they were being studied but that simply underscores the point: More attentiveness means fewer deaths. One of the secrets of health reform is that there's substantial opportunity within the system to make it cheaper while making it better. Instead, the discussion proceeds as if we were facing a tradeoff in which every dollar saved is a dollar of health lost. We're not. A system where all the records are written on paper and tucked in manila envelopes, where surgical deaths drop by 40 percent with the addition of a 19-item questionnaire, where prescriptions are scrawled on scraps of notepad, and where there's little in the way of independent evidence demonstrating cost-effectiveness is not a system that lacks for expensive inefficiencies. 
