The book starts with the case of a 18 month old child with severe burns that is brought to John Hopkins medical centre. During her stay there she develops several infections, partly due to an infection of her central line, that leads to her death. This case had a huge impact on the hospital since to all people involved it was clear that her death was unnecessary with a better organization in the hospital. This led to a project where a simple checklist decreased central line infections from 11 in 1000 catheter days to zero. Continue reading “Book: Safe patients, smart hospitals by Peter Pronovost”
Book: Checklist Manifesto by Atul Gawande
Atul Gawande is a famous surgeon from Boston that previously had published books about his profession. His book “Checklist manifesto” is about his interest in working with checklists in the hospital environment and his involvement in the creation and test of the WHO checklist. Continue reading “Book: Checklist Manifesto by Atul Gawande”
Normal accidents
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Onlangs heb ik het boek gelezen “Normal accidents” van Charles Perrow. Interessant boek uit 1999 dat een aantal risicovolle sectoren beschrijft en hoe daar omgegaan wordt met veiligheid en risico’s. Centraal thema van het boek is de matrix met aan de ene kant mate van gëintegreerdheid van systemen en aan de andere kant de mate van complexiteit. Continue reading “Normal accidents”