Published on Friday, February 12 2010
Imagine if you discovered a new medical procedure that could be used in every Intensive Care Unit in the world.
One proven to reduce infection rates, save lives, and reduce hospital operating costs by millions of dollars a year.
That costs next to nothing to manufacture or deploy.
That is so simple to operate that a kindergartner already knows how.
And that most doctors refuse to use, despite the clear evidence for its safety and efficacy.
That's just the position that Peter Provonost, a critical care specialist at Johns Hopkins University, found himself in 2001.
He wanted to tackle a specific problem: infections that occur when an IV line is put into a patient.
5 Simple Steps
Theoretically, these infections are 100% preventable if doctors just follow five simple steps:
(1) wash their hands with soap
(2) clean the patient’s skin with chlorhexidine antiseptic
(3) put sterile drapes over the entire patient
(4) wear a sterile mask, hat, gown, and gloves
(5) put a sterile dressing over the catheter site once the line is in
In case you've never gone to medical school, this isn't exactly the sort of stuff that causes would-be doctors to flunk out in despair. Not exactly rocket science, or heart surgery, or even organic chemistry. Basic procedure that every med student, resident and intern has been taught – and done – a thousand times.
Yet when he asked ICU nurses to record how well doctors performed these five steps, he was shocked: fully one-third of the time, at least one step was skipped.
Leading to infections among ICU patients, who are among the last people in the world you want to infect. They don't respond that well to opportunistic infection, turns out.
In response, Provonost instituted a simple 5-step checklist that doctors had to complete for every line they put in. They balked at the "extra paperwork," so nurses were authorized Nurses were authorized to stop doctors who skipped a step, with administrative backup to intervene if necessary.
What happened? Atul Gawande, writing in The New Yorker, relates:
Pronovost and his colleagues monitored what happened for a year afterward. The results were so dramatic that they weren’t sure whether to believe them: the ten-day line-infection rate went from eleven per cent to zero. So they followed patients for fifteen more months. Only two line infections occurred during the entire period. They calculated that, in this one hospital, the checklist had prevented forty-three infections and eight deaths, and saved two million dollars in costs.
The lowly checklist, as powerful as any drug or procedure developed in the past 50 years?
Checklists for Everything
Gawande makes a strong case for the use of checklists in his new book, The Checklist Manifesto. Anywhere you have a complicated situation and a high cost of failure, create a checklist.
Not any checklist will do. It turns out, Gawande discovered, that there's an art to writing good checklists. (For full details, read his book.) The right kind of checklist can save 200 lives when a plane loses an engine and has to glide to a landing in the Hudson River. The wrong kind can discombobulate the co-pilot so much that he can't think.
Your Free AdWords Checklists
I realize that AdWords is not the same as critical medical care or air safety, but it's still a complicated situation, and if it's your business, a high cost of failure.
With that in mind, I've created a bunch of AdWords checklists, following the AdWords best practices I teach in Traffic Surge, Profit Surge, and AdWords Checkmate, and the checklist best practices I learned from The Checklist Manifesto.
They include:
1. Keyword Research Checklist
2. Ad Preparation Checklist: Search Network
3. Ad Writing Checklist
4. Ad Split Testing Checklist: Top Level
5. Ad Split Testing Checklist: Lowest Level
You can download them here, absolutely free.
And you can find out how to get a video and PDF tutorial on using the Checklists for only $2.30. Just scroll to page 6 in the download.
