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　　研究显示，采取一些比较简单和低成本的医疗质量控制措施，就可以减少感染的发生，挽救生命。

　　Hospitals can be dangerous places. We go there to get well, but sometimes people get sicker or even die because of infections they contract in the hospital.

　　医院也可能是个危险的地方。我们去医院是为了治病，但是有时会因为在医院遭受感染而病情加重，甚至死亡。

　　Johns Hopkins University Medical School professor Peter Pronovost pioneered the use of hospital checklists to reduce infections.

　　约翰霍普金斯大学医学院教授彼得·普罗诺沃斯特率先使用医院工作检查清单，以减少感染率。

　　He and his colleagues started with a list of about 90 recommendations from the U.S. Centers for Disease Control and Prevention, "and we elected to say, well, I can't do 90 things as a practicing [doctor]. Let me cull² it out and pick the five most important things on that guideline and make sure we do those."

　　他和同事们从美国疾病控制和预防中心的大约90项建议开始做起。普罗诺沃斯特说：“有些医生会说，作为一名执业医生，我不可能做所有这90件事。 那我就把它们一一去掉，精选出5件最重要的，而且确保要把它们做好。”

　　They focused their program on reducing infections in the central line, the tube inserted by needle into a patient’s vein³ to deliver medications and for other purposes. Central lines are a common source of serious infection in hospital intensive care units.

　　他们将降低感染率的重点放在中央线上，也就是为病人做静脉注射所使用的针管。中央线是加护病房里发生严重感染的常见源头。

　　The checklist includes simple things like hand washing and disinfecting the skin before the central line is inserted. It has previously⁴ been shown to reduce the infection rate to near zero.

　　这份工作清单包括一些简单的措施，例如在做静脉注射之前的洗手和消毒皮肤。以往的经验显示，这些措施可以使感染率降低至接近零。

　　But did a lower infection rate translate to a lower death rate?

　　但是，低感染率是否就意味着低死亡率呢？

　　To find out, Pronovost and his colleagues compared hospital deaths in the state of Michigan, where the checklist program was in use, with nearby states that weren't in the program.

　　为了找到答案，普罗诺沃斯特医生和他的同僚们，将使用这个工作清单的密西根州医院的死亡率，和临近还没有使用这种方法的州进行比较。

　　"What we found was that the mortality of patients in Michigan went down by 10 percent more than if they were in the 11 surrounding states."

　　他们发现，密西根州的病患死亡率比临近11 个州下降了百分之10以上。

　　While the quality improvement program may be built around a simple checklist, Pronovost stresses that it really is about changing how medical staff work together so that, for example, doctors listen to nurses, not just the other way around.

　　普罗诺沃斯特教授强调指出，一个简单的工作清单固然有助于提高医疗质量，但这实际上涉及的是医务工作者应当如何在一起工作，例如，医生要倾听护士的意见，而不仅仅是护士听医生的。

　　"A big part of our program was this culture change, because when doctors were using the checklist, 25 percent of the time they forgot [one of the items], so we asked the nurses to work with the doctors. And if the nurses saw the doctors not comply with the checklist, they can make the doctors go back and fix the mistake."

　　他说：“我们这个项目一个主要内容就是这种文化上的改变。因为当医生们使用工作清单时，他们会有百分之25的可能性忘掉其中一两项。所以我们要求护士和医生一起做。如果护士发现医生没有遵照清单执行，他们可以请医生回过头来改正错误。”

　　Pronovost says the quality improvement program is cost-effective and well-suited to resource-poor hospitals and clinics. "We've done it in Peru and we've just started a program in Pakistan and we're looking to put it into Africa. So it absolutely works."

　　普罗诺沃斯特教授说，质量改进项目对于资源贫乏的医院和诊所来说，是既省钱、又适用的方法。他说：“我们在秘鲁这么做过。我们刚开始在巴基斯坦推行这个项目。我们还希望把它推广到非洲去。因为它绝对有功效。”

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