Leadership Principles for Health Care Organizations


In 2006, researchers published results of a program designed to prevent specific types of hospital infections in intensive care units. The program involved a simple, five-step checklist to remind physicians that before implementing specific procedures, such as inserting central lines into patients, they should carry out routine precautions (for example, washing their hands and wearing a sterile gown and gloves). After 3 months of using the checklist, the rate of bloodstream infections from the central lines was decreased by two thirds. Researchers estimated that in the 18-month period following implementation of the checklist, the program saved more than 1,500 lives and nearly $200,000,000 (Gawande, 2007).

In spite of these amazing results, the Office for Human Research Protections (OHRP) in Michigan—where the checklist program had been implemented—halted the program. Further, the research hospital was required to discontinue its plans to extend the program to hospitals in New Jersey and Rhode Island. Why was this decision made? The OHRP ruled that federal monitoring and written informed consent from patients should be required for the study in the same way that these would be required for the research (Gawande, 2007).

  • Respond to the following question:
    • Does the quality improvement in health care outweigh the rights of the patients who did not give their consent to be part of the research?
  • Locate 3 different peer-reviewed articles on ethical treatment of subjects in clinical research, and post 1 of the articles as an attachment.
  • State whether you agree or disagree with the Michigan Office for Human Research Protections’ response that the quality improvement checklist initiative was questionable and even dangerous.


Gawande, A. (2007, December 30). A lifesaving checklist. New York Times. Retrieved from www.nytimes.com/2007/12/30/opinion/30gawande.html