Articles: checklist.
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Am. J. Obstet. Gynecol. · Jul 2014
Maternal mortality in the United States: predictability and the impact of protocols on fatal postcesarean pulmonary embolism and hypertension-related intracranial hemorrhage.
The purpose of this study was to examine the efficacy of specific protocols that have been developed in response to a previous analysis of maternal deaths in a large hospital system. We also analyzed the theoretic impact of an ideal system of maternal triage and transport on maternal deaths and the relative performance of cause of death determination from chart review compared with a review of discharge coding data. ⋯ Disease-specific protocols are beneficial in the reduction of maternal death because of hypertensive disease and postoperative pulmonary embolism. From 2-6 women die annually in the United States because of cesarean delivery itself. A reduction in deaths from postpartum hemorrhage should be the priority for maternal death prevention efforts in coming years in the United States.
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Letter Historical Article
Standardization of surgical procedures: beyond checklists?
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High-quality checklists are essential to performance test score validity. Prior research found that physical exam checklists of items that clinically discriminated between competing diagnoses provided more generalizable scores than all-encompassing thoroughness checklists. The purpose of this study was to compare validity evidence for clinically discriminating versus thoroughness checklists, hypothesizing that evidence would favor the former. ⋯ Limiting checklist items to those affecting diagnostic decisions resulted in better accuracy and psychometric indices. Thoroughness items performed without thinking do not reflect clinical reasoning ability and contribute construct-irrelevant variance to scores.