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Hospital checklists, part 1: preventing surgical errors

Hospital checklists are more than an idea whose time has come. Research is now beginning to show that such checklists can be effective at preventing errors in the delivery of medical services.

As we will discuss in this two-part post, however, in order for checklists to be effective, medical professionals really do have to follow them.

In a sense, it's like the oft-cited advice for people to eat their vegetables and exercise regularly in order to improve their overall wellness. It isn't enough to admit something is a good idea; to receive the benefits, you have to actually put it into practice.

In this part of the post, we will discuss research evidence regarding how checklists can help prevent surgical errors.

The research was presented recently to the American Society of Anesthesiologists. It involved an analysis of the implementation of a surgical safety checklist issued by the World Health Organization (WHO).

WHO created the checklist a few years ago in an effort to reduce surgical complications. It identifies a total of 26 tasks that should be accomplished in connection with surgery, divided among three different phases.

The first phase is before anesthesia is administered. The second is the period between the administration of anesthesia and when the surgeon makes the incision. The third phase extends until the patient leaves the operating room.

Some of the checklist items seem utterly basic, but are nonetheless important. Confirming the site of the body where the surgery is to be performed should of course be a no-brainer. But because wrong-site surgery still sometimes happens, surgical protocols that require conformation of the site can play a key role in preventing surgical errors.

So what were the findings of the research on implementation of the WHO checklist?

There were key differences in all three stages of surgery. In the third stage, for example, the formal counting of surgical objects (such as sponges and instruments) was done 87 percent of the time when a checklist system was in place. This compared to only 19 percent without the checklist.

Source: HealthDay, "'Doctor, Please Review This Checklist Before My Surgery'," Jan. 24, 2014

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