Midwife Connection

Tip of the week by Cassie Moore, ACNM writer and editor

Sometimes the answers to our big problems are so small and easy, they seem like they couldn’t possibly be the right solutions.

If you haven’t already, take a look at this interesting article from The New York Times, The Simplest Health Solutions? It’s Complicated, in which author Abigail Zuger, MD, talks about how the simplest things—like soap!—have made a huge difference in terms of public health. When the ACNM staff recently sat down for a screening of “Birth of a Surgeon,” a PBS documentary following midwives-in-training in Mozambique, it was evident that just a few simple little things—a generator that ran long enough to provide light for operations, a supply of basics like rubber gloves—would be a tremendous help to clinicians (and moms and babies) there.

So what’s the next big little thing? A checklist. Believe it or not, an ordered list of actions that must be done during a medical procedure actually makes a big difference in patient safety. Zuger writes,

Schoolchildren have made these lists for centuries, but doctors, incredibly, have not. In arenas like the operating room—where success depends on the integration of many different agendas, a dozen kicking chorus lines moving seamlessly across the stage—medical professionals working together never thought to make a master list.

Then Dr. Peter J. Provonost, a critical care specialist at Johns Hopkins, showed several years ago that a variety of endemic hospital problems could be virtually eliminated with checklists. Lists efficiently overcame staff forgetfulness, haste and overconfidence, and rates of intravenous catheter infections, pneumonias and a variety of medical errors plummeted. Checklists are now becoming routine; whether they will go the way of the bar of soap, improved beyond all recognition, remains to be seen.

ACNM has added a printable checklist that can be copied and used the in the clinical setting to our award-winning PowerPoint presentation, Evidence-Based Practice: Pearls of Midwifery. The checklist describes the practices that facilitate physiologic birth and can be referred to quickly and easily during all stages of labor and birth. The presentation and checklist are free to ACNM members, so download yours today!