Little lists, big impact

Atul Gawande, professor of health policy and management

Winter 2013 ]

If health care workers use simple checklists during critical moments of care such as surgery and childbirth, they can greatly reduce death and complications among their patients. In study after study, Atul Gawande, professor of health policy and management at Harvard School of Public Health (HSPH) and a surgeon at Brigham and Women’s Hospital (BWH), has replicated this finding.

Now, three new significant gifts will help support the efforts of Gawande and his colleagues as they launch a new center aimed at patient safety and improved health systems. The center is a collaboration between HSPH and BWH.

Donors include Mala Gaonkar, AB ’91, MBA ’96, who pledged $5 million; Richard Menschel, MBA ’59, who pledged $2.5 million; and Blue Cross Blue Shield of Massachusetts, which pledged $1 million. These contributions follow another major gift made in 2011 in support of Gawande’s work: $14.1 million from the Bill & Melinda Gates Foundation to test the effectiveness of the child-birth safety checklist in 120 hospitals in India.

Surgery and childbirth: Risky business

Every year, half a million people in the United States and another 7 million around the world either die or become disabled as a result of surgery. And of 130 million births, roughly 287,000 result in the mother’s death, 1 million in stillbirths, and another 3.1 million in infant deaths during the first 28 days of life. Gawande thinks many of these deaths and complications can be prevented if doctors and health care workers follow simple and low-cost procedures to ensure success and safety.

Gaonkar, a partner and managing director at Lone Pine Capital, LLC, is impressed with the “elegant simplicity” of Gawande’s checklist concept. “When I make contributions, I look for who is doing the strongest, most innovative work, and whether they have the capability to test their concepts in multiple locations around the world,” she says. “A great deal of money is being invested in pharmaceutical and biotechnology research these days, but very little is devoted to less glamorous ideas in systems innovation that have real potential to improve health care delivery around the world.”

Tackling fundamental issues

According to Menschel, managing director of the Charina Endowment Fund and senior director at Goldman Sachs, “Atul is tackling what I see as fundamental issues in health care—issues that others haven’t focused on or solved.”
Adds Blue Cross Blue Shield CEO Andrew Dreyfus: “One of the big missing ingredients in the quality and safety movement has been the ability to scale up interventions that we know work. Atul and his colleagues have developed proven methods to rapidly deploy new safety measures.”

“These new sources of funding will give us a chance to build an infrastructure to launch projects that work across more of health care,” notes Gawande. “Our goal is straightforward: We want to drive scalable solutions for better care at the critical moments in people’s lives everywhere.”

Karen Feldscher