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Atul_Gawande's profile
Atul Gawande
Atul Gawande
Atul Gawande
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@Atul_Gawande

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Atul GawandeVerified account

@Atul_Gawande

Surgeon, Writer, Researcher, Dilettante. https://www.ariadnelabs.org/  http://www.lifebox.org/ 

atulgawande.com
Joined January 2011

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    1. Atul Gawande‏Verified account @Atul_Gawande 14 Dec 2017

      Atul Gawande Retweeted NEJM

      In one of the largest facility-based randomized studies of child delivery, conducted in partnership w/ Govt of India and UP, @WHO, @PSIimpact & others, we sought to improve the uptake of essential birth practices & reduce neonatal/maternal morbidity & mortality. #BetterBirthhttps://twitter.com/NEJM/status/941066504417808384 …

      Atul Gawande added,

      NEJMVerified account @NEJM
      Adherence to essential birth practices increases with the use of the coaching-based @WHO Safe Childbirth Checklist program, but does not reduce maternal or perinatal mortality or maternal morbidity. http://nej.md/2BiSfjq  pic.twitter.com/HyaUAIKmCQ
      8 replies 118 retweets 268 likes
      Show this thread
    2. Atul Gawande‏Verified account @Atul_Gawande 14 Dec 2017

      The key points: Poor quality of care at childbirth has been recognized globally as a major contributor to high rates of death for mothers and babies in childbirth. 1/12

      3 replies 21 retweets 27 likes
      Show this thread
    3. Atul Gawande‏Verified account @Atul_Gawande 14 Dec 2017

      WHO’s Safe Childbirth Checklist was designed to help birth attendants & managers better insure women receive essential care for the biggest killers, eg washing hands + using clean gloves to prevent infections; monitoring and treating BP to stop eclampsia. 2/12

      1 reply 7 retweets 20 likes
      Show this thread
    4. Atul Gawande‏Verified account @Atul_Gawande 14 Dec 2017

      We found coaching attendants and managers in rural clinics across Uttar Pradesh, India, to use the checklist to recognize and address gaps in practices, resources, and organization lifted them in 2 months from delivering 42% to 73% of essential safe practices. 3/12

      1 reply 7 retweets 19 likes
      Show this thread
    5. Atul Gawande‏Verified account @Atul_Gawande 14 Dec 2017

      On the one hand, this was remarkable, rapid change at such large scale. On the other hand, it wasn’t enough to reduce stillbirths, perinatal mortality, or maternal mortality/morbidity. 4/12

      1 reply 6 retweets 25 likes
      Show this thread
    6. Atul Gawande‏Verified account @Atul_Gawande 14 Dec 2017

      So what to make of this? A few important lessons: - Large scale improvement IS possible even in tough, resource-limited settings. - It required changes not just in bedside practices but also in mgmt practices. - The plan was good but did not produce sufficient change. 5/12

      4 replies 13 retweets 66 likes
      Show this thread
      Atul Gawande‏Verified account @Atul_Gawande 14 Dec 2017

      What more is needed? We and others will test the question now. Possibilities: A. We should have stayed longer than 8 months. Our other large studies (eg in surgery) are showing 3 years or longer to produce large scale, sustainable change in outcomes. @AriadneLabs 6/12

      6:18 AM - 14 Dec 2017
      • 5 Retweets
      • 24 Likes
      • Signpost Poetry HarvardPublicHealth pacoramon Mary Sue Rennells Meg Carter Fionnuala Ní Áinle meena kumari Dr. Ron George 👨‍⚕️🇨🇦 Anesthesiologist Alan Rogers
      1 reply 5 retweets 24 likes
        1. New conversation
        2. Atul Gawande‏Verified account @Atul_Gawande 14 Dec 2017

          B. Managers and district leaders need stronger forms of accountability for quality improvement. 7/12

          2 replies 7 retweets 17 likes
          Show this thread
        3. Atul Gawande‏Verified account @Atul_Gawande 14 Dec 2017

          C. We should implement supply and skill upgrades before implementing checklists/coaching. 8/12

          2 replies 7 retweets 18 likes
          Show this thread
        4. Atul Gawande‏Verified account @Atul_Gawande 14 Dec 2017

          D. The NEJM editorial argues rural clinics are inherently too limited and deliveries need hospitals with surgical and other capabilities. http://www.nejm.org/doi/full/10.1056/NEJMe1713831 … 9/12

          1 reply 5 retweets 14 likes
          Show this thread
        5. Atul Gawande‏Verified account @Atul_Gawande 14 Dec 2017

          E. ???? 10/12

          3 replies 1 retweet 8 likes
          Show this thread
        6. Atul Gawande‏Verified account @Atul_Gawande 14 Dec 2017

          Bottom line: #BetterBirth was the most ambitious, difficult, and important effort I’ve ever been part of. It has provided deeper, more profound information than we’ve ever had about how we make progress in saving women and babies’ lives. 11/12

          4 replies 20 retweets 85 likes
          Show this thread
        7. Atul Gawande‏Verified account @Atul_Gawande 14 Dec 2017

          I could not be prouder of anything I’ve ever undertaken. @k_semrau @Vishwajeet_CEL @WHO @PSIimpact @AriadneLabs #BetterBirth 12/12

          7 replies 7 retweets 83 likes
          Show this thread
        8. End of conversation

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