Safety checklists are beneficial for operating room teamwork and communication and this may be one mechanism through which patient outcomes are improved.
I agree with respected @Prof. Kamal and @Manouchehr Amiri. Such safety checklists are set practices in many organizations because it is never possible to remember by heart every safety aspect during checking. Indeed, such arrangements improve teamwork and communication in the operating room. However, such lists needs to be revised regularly as new threats are always growing.
Great discussion. Checklist (safe surgical checklist, SSI) are adopted from the aviation industry, and there are an increasing body of evidence that they decrease surgical adverse events. In a recent trail published in Annals of Surgery by Haugen at al they conclude that checklist was associated with robust reduction in morbidity, lenght of stay and some reduction in mortality. (Haugen AS, Søfteland E, Almeland SK, Sevdalis N, Vonen B, Eide GE, et al. Effect of the World Health Organization Checklist on Patient Outcomes. Annals of Surgery. 2014 May;:1)
The cornerstone paper regarding checklist were published in NEJM in 2009:
(Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat A-HS, Dellinger EP, et al. A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population. N Engl J Med. 2009 Jan 29;360(5):491–9).
SSC may be useful in clinical settings with complex teamwork and decison making, like multidiciplinary teams, clinical handover, trauma among others
The W.H.O. 'safer surgery saves lives checklist' is an international mandatory requirement and should be used world wide. This was implemented in the U.K during 2009 and is used routinely in all departments where invasive procedures are practiced.
Definetly but the most mportant is the motivation to perform safe surgery and the administrators play an even more important role in introducing the system and implementing the same
What is surprizing is not that the checklist helps. The surprizing data, at least for me, is the magnitude of the reduced morbidity and mortality that using such a simple and seemingly trivial set of items on the checklist. But the data is clear cut.
Excuse me, but I would like to know: Before or during each surgery, are there engineers to do safety tests on electromedical equipment such as electrosurgical units, cardiac monitors, defibrillator or the surgical table?
Surgical checklists (such as WHO) have become standard practice, and are vital for preventing wrong patient, wrong site, wrong side errors. Also enhances team approach to surgery
I am sorry to disagree with the majority of the respondents but safety checklists do not, in and of themselves, improve teamwork and communication in the operating room. I fact, due to resistance to adoption in the period after introduction of checklists in an institution, they may actually worsen communication and strain teamwork.
OK, sorry for the contrarian view but I believe that the question that Dr. Awad asked and the one most of us are answering are not the same. While it is unquestionable that checklists have improved safety and outcomes from flight operations to convoy safety in Iraq and Afghanistan to almost all aspects of healthcare to which they have been applied, the important point is that it is never the checklist itself that is responsible for process improvement. This is evident by the fact that the magnitude of that improvement is not dependent upon any particular checklist. The key to using the checklist effectively is in developing and nurturing teamwork among those in high stakes positions. The checklist process can be the focal point of that development if it is introduced into the institutional culture in a thoughtful manner with input from all players. If the message on introduction of the checklist focuses on safety and teamwork and empowerment and shared responsibility then the results are more likely to be improved process efficiency and outcome with a side benefit of improved compliance and staff satisfaction. If, however, the message is all about compliance and consequence and regulation of behavior then the result is likely to range from superficial compliance (i.e. going through the motions) to blatant non-compliance.
The time to consider how to build teamwork and communications is before introduction of checklists and other quality-indicator-relevant metrics. If your teams are not developing apace with your quality and outcome improvement projects then you should be prepared to be disappointed with the results. Checklists are absolutely the answer for preventing errors and improving outcomes in the OR. They will not develop teams or clarify communications for you but they can be one useful tool in your team development/communications toolkit. Good luck.
Certainly the introduction of OR checklists helped in preventing errors and improving outcomes. However, they never improved team-work or communication. The latter does not a checklist to make it a reality! I totally agree with Frank Cannizo in his comment.
I think safety checklist reduce adverse events only if implemented conscientiously and effectively in the presence of all team members. it should not be considered a chore but an important aspect of surgical intervention