It’s one of my favourite commercials. You see a woman fussing around her perfectly decorated home, making sure her holiday table is just so. The candles are lit, the wine is poured and a gentle wave of Christmas classics breeze over the scene. Then the doorbell rings, and as our Martha Stewart protégé turns to greet her first guest, you see the back of her cocktail dress tucked into her pantyhose. I guess you can glean 3 key messages from this whole scenario: nobody’s perfect, haste makes waste or it’s the little things that can really make a difference. I tend to favor the latter.
In the world of holiday entertaining, a small oversight like this wouldn’t make the difference between life and death (unless dying from embarrassment counts…). In the world of medicine, however, the devil is truly in the details. And that’s especially true in the intensive care unit, or ICU, which houses the sickest patients in the hospital. If you’ve never been to one, consider yourself lucky. If you have, you’ll never take simple things like being able to breathe on your own for granted again.
Clinical teams in any ICU can be so busy treating the big problems they may overlook the small and relatively simple opportunities that can make a huge impact on patient outcomes. Consider this: for patients on a ventilator, raising the head of their bed can help prevent a serious lung infection called pneumonia. A simple 45 degrees can turn a situation 180. Who would have thought?
It was news to me, but not to Sunnybrook Intensive Care Specialist Dr. Damon Scales. He and his research team wanted to find a way to bring the little things back into focus. What followed was a very cool study that has never been done before. It linked the ICUs of 15 community hospitals across Ontario through videoconferencing. Through educational seminars and simple checklists (similar to those used by pilots before takeoff), 6 small but powerful interventions made it back on the radar.
Dr. Scales says this was an extremely rewarding project. The rates of complications and death are higher in the ICU than any other area of the hospital, so focusing on the details means the most vulnerable patients benefit. In the first year of this Sunnybrook-led study, more than 9,000 patients were impacted, and adherence to some of these practices more than doubled. And those benefits continue. After all, once you know better, you can do better.
Now that you know the big picture, read all about the study details here.
