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Checking in on medical checklists, part 2: emergency services

In the first part of this post, we sketched the origins of the movement to develop checklists to help prevent medical errors.

As we noted, two of the key figures were Atul Gawande and Peter Pronovost. More than a decade ago, Pronovost proposed a protocol for infection-prevention in the ICU. And in 2009, Gawande contributed an influential book called 'The Checklist Manifesto."

In today's post, let's look at the current question of how checklists could be extended to emergency medical services (EMS) to help prevent errors there as well.

Initially there was concern in the EMS community that checklists would take too much time to apply in emergency settings because rapid response is so crucial in that context.

One EMS practitioner reached out to Gawande to pose that question. Gawande pointed to a study that had been done on the use of surgical checklists during simulated operating-room emergencies. The study found that use of a checklist reduced mistakes by 75 percent.

Gawande knows whereof he speaks. His advocacy for the successful use of medical checklists has been recognized on the world stage.

In particular, the World Health Organization (WHO) called on him to identify ways to reduce surgical errors and increase the overall safety of surgery. At Gawande's urging, the WHO got behind the checklist movement.

Checklists designed by WHO are now standard in more than 20 countries. As a result, complications from surgery and death rates have declined where checklists are used.

The EMS setting is also embracing the checklist movement. Of course, in the EMS setting there is a need for multiple checklists, because emergency care can involve so many different types of medical conditions. But many checklists have already been developed.

As in the hospital setting, however, the process of getting them adopted and implemented effectively is another story entirely.

Source: JEMS, "EMS Checklists: Highlighting criticdal areas of the protocols not to be missed," Cynthia Kincaid, Accessed Feb. 28, 2014

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