THE CHECK LIST
Kevin Smith: ‘I’m with a large hospital here in Indianapolis and I’d seen the New Yorker checklist article … was glad to see you pick up on it this week. However, you’ll probably want to see this – the program’s being shut down! Pretty sad!’
☞ Not just sad – outrageous:
. . . The results were stunning. Within three months, the rate of bloodstream infections from . . . I.V. lines fell by two-thirds. The average I.C.U. cut its infection rate from 4 percent to zero. Over 18 months, the program saved more than 1,500 lives and nearly $200 million.
Yet this past month, the Office for Human Research Protections shut the program down. The agency issued notice to the researchers and the Michigan Health and Hospital Association that, by introducing a checklist and tracking the results without written, informed consent from each patient and health-care provider, they had violated scientific ethics regulations. Johns Hopkins had to halt not only the program in Michigan but also its plans to extend it to hospitals in New Jersey and Rhode Island.
The government’s decision was bizarre and dangerous. But there was a certain blinkered logic to it, which went like this: A checklist is an alteration in medical care no less than an experimental drug is. Studying an experimental drug in people without federal monitoring and explicit written permission from each patient is unethical and illegal. . .
☞ Let’s not rest until we get this fixed. This one is so basic and obvious, even the Bush Administration should be able to get it right. And that’s saying something.
As in, the Commissioner. Wasn’t that the name of a TV series? (I rub Google’s tummy . . . yes!) I assume it was about a police commissioner.
This is about a water commissioner. I gave $500 to help get her elected, giving me a 100% batting average. Every time I support the candidacy of a water commissioner, she wins. (Long story; her brother gives to the DNC, she got it into her head to run for this, so next thing you know I’ve got my money on Debra Shore for a seat on the Chicago Water Commission.)
And there are two things I want to tell you about her.
– Her Essay
It ran on Chicago Public Radio, and it’s really lovely. Read or listen to it here. Just a sweet little piece about how hard it is to put yourself out there and run for office. (‘It was the most humbling experience of my life. As a candidate, you go out in the face of colossal indifference and sometimes outright hostility. . . .’) Go ye and do likewise.
– Her First Year
The only thing I’d thought about less than ‘how are water commissioners selected?’ is ‘what new life could they possibly bring to the job?’ I mean: water should be potable and plentiful (Chicago sits on a Great Lake, how hard can it be?); no leaks. End of story.
But no, the report she issued on her first year had some really interesting ideas.
- Like making rain barrels available at cost ($40) for Chicagoans to put under their rain gutters. ‘Using rainwater means you are not using – or paying for – filtered drinking water. And the captured rain, when used to water your garden during a dry spell, then helps to recharge our underground aquifers rather than flowing into the sewers as it would during a storm.’ (For more on this idea for your own rain gutters, click here. For an example of some of the features of a pricier rain barrel, here.)
- Like using permeable paving materials ‘to allow rainwater to infiltrate the ground’ rather than, again, enter the sewer system. Debra refers us to this site for more.
- Like caffeinating the water supply, so people will just feel perkier. Which is my idea, not Debra’s, but it’s always fun to see whether you’re paying attention.
One of the links at the end of the report lets you click on each room in your house for water-saving tips.
Quote of the Day
Spending tens of thousands of dollars on a person's last few months of life is compassionate, but spending tens of thousands of dollars to improve a person's first few years of life is investment.~.
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