The art is to make sure that checklists are used effectively, not excessively. It is easy to identify checklists that could be added in many healthcare settings, but if they have too many items or are otherwise burdensome, they can do more harm than good. My sense is that we need more checklists overall, but that we need to add them very carefully and make sure that they fit in with clinical workflow. For a great discussion on the topic, you can read Atul Gawande's "The Checklist Manifesto". It is a quick, informative, and engaging read. Bottom line: don't try to implement a checklist unless you have buy-in from front-line providers to actually use it.

I agree with Daniel. I've heard the response of 'Oh yes we're very good at checking off boxes' in response to whether the WHO surgical checklist was being used. Without genuine engagement and some sort of ongoing monitoring effort, the checklists could become a complete waste of time. It is important to ensure objective recording of the checkboxes and try to correlate their use with outcomes eg adverse events in the OR or subsequent infections and pre-op antibiotics etc.

Gisborne Hospital (Tairawhiti District Health, New Zealand) has been one of the few hospitals in NZ still carrying on checklist and, overall, courses in Human Factors in the operating theater. There were mix responses to the whole program, with some teams quite enthusiastic and others less so.