Speaking Up for Surgical Checklists and Patient Safety

| Roxanne Blanford

Health care professionals are at risk for committing errors in patient treatment every single day.  Afterall, they're only human.  The good news is that many of these risks may be considerably reduced with the aid of surgical checklists.

There has been considerable research involving human behavior in stressful occupations. This includes aviators and pilots, high-risk investors and skyscraper builders and, more to the point, surgeons and other medical personnel. 

The implementation of surgical checklists has been shown to play a significant role in reducing complications (i.e., massive blood loss, respiratory failure, medication errors). As a safety tool to assist in standardization of protocol and to reinforce behaviors that are more predictable, checklists have now become commonplace in healthcare practice to ensure procedural compliance for the benefit of patient safety and have proven to be effective in areas such as

  • safer anesthesia management

  • airway function

  • correct surgical site/side

  • infection prevention

  • effective teamwork and communication

READ: Reducing Medical Errors with Simulation

What Is A Checklist and What Is Its Value?
A checklist is essentially a list of action items, or criteria, that are arranged in a systematic manner. The list allows the user to track, record, and/or verbally confirm adherence to procedure.

Checklists also help ensure that certain conditions or processes are acknowledged, considered, attended to, and/or completed according to protocol.

Checklists have been successfully utilized in aviation training to assist in the documentation of procedures. This facilitates a culture of accountability and reliability because when used properly, a checklist can:

  • aid memory and facilitate team communication

  • structure and formalize team interaction, training, workflow, and specific roles

  • aid operational efficiency and team satisfaction

  • act as a framework for skills evaluation and assessment

In medicine, checklists can provide professionals with guidance and can help to minimize patient risk.

In 2008, the World Health Organization (WHO) published a document recommending surgical checklists as a means to decrease preventable accidents during surgical procedures.  When implemented properly, the WHO Surgical Safety Checklist (available here) has been associated with reduced complications, reduced mortality rates, and better compliance with established safety standards.


What tools are you using to help  improve patient safety?

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