SHEA Consensus Panel Report: A Smooth Takeoff

Abstract

Icing . check. Strobe lights . on. EICAS (electronic indicating crew alert system) . recall. Transponder . check. These are just a few of the approximately 100 line items that the pilot and copilot review as part of the takeoff and landing of a Boeing 767 aircraft. Most of the airline industry has standardized the checklist for its flight crews so that any randomly picked group will be able to work together smoothly and will know one another's assignments. This structured system often is cited by qualityimprovement experts as a model for other industries. Medicine has begun to emulate the qualityimprovement model with the development of core recommendations for various clinical situations, clinical practice guidelines that include evidence-based recommendations and expert opinion to assist clinicians and patients, and disease-management strategies that attempt to integrate healthcare delivery systems to improve clinical results and to reduce costs.' The development of such documents and plans is facilitated by the availability of clinical evidence from scientifically conducted studies and, in the absence of rigorous scientific evidence, by the consensus opinions of experts in disease management and clinical outcomes. Hospital epidemiologists have begun to consider the utility of infection control practice guidelines and core recommendations. The Society for Healthcare Epidemiology of America (SHEA) has produced a long and influential series of position papers on a variety of specific topics. Similarly the Centers for Disease Control and Prevention (CDC) and its Hospital Infection Control Practices Advisory Committee (HICPAC), the Association for Professionals in Infection Control and Epidemiology, Inc. (APIC), and the Surgical Infections Society, among other professional organizations, also have produced important position papers and guideline statements.