There has been some interest around the concept of using a short, simple checklist as a means of preventing surgical “non-events” – operating on the wrong patient, wrong procedure, or wrong site. I’ve written about the topic before, including the federal order to stop a test of checklists because of purported patient consent issues.
The New England Journal of Medicine (NEJM) today reported on a completed study under the WHO’s “Safe Surgery Saves Lives” Initiative”. The outcome of the study, conducted in eight cities around the world, found that the incidence of death and complication was reduced by one-third.
Science Daily has an excellent discussion today on its website. You can access the WHO material, including the checklist, here.
Surgery, in particular, is a complex system – there are many people who were involved in the run up to surgery, and most are not present in the operating room. Information was often transcribed from one report to another, increasing the opportunity for error. We also pull together a new team for each operation – while they may have worked together before, maybe even many times, there may be enough differences that could lead to a miscommunication and error.
The promise, here, is that a partial and important solution to errors is through the discipline of a checklist. The airline industry, which also pairs cockpit crews on an ever changing basis, has adopted checklists as one of several key steps to reducing accidents – an effort that saw a five year span without an accident. Checklists do not require expensive equipment, investments, or reimbursement. They do require thought, a testing period, and can be readily revised as needed.