If checklists work for surgery, what else could they work for…?

Not so long ago, an error in a Boston hospital led to a patient undergoing ‘wrong-side’ surgery, and the procedure was done on the wrong body part. The hospital and its CEO, Paul Levy, was admirably transparent about the whole situation, letting staff and the wider public know what had happened. As well as an investigation they also set up a “Safety Culture Operational Task Force co-chaired by a nurse, a surgeon, and an anesthesiologist, and engaging almost two dozen other people from a variety of disciplines and positions in the hospital.”

What they came up with was a checklist that all surgical teams have to go through before each surgery: “Responsibilities and the order of events is clearly laid out, even to the point of requiring that any radio in the OR is shut off during the time-out so as to avoid aural distraction. Note the forcing function at the very top of the form: No blades, needles, specula or bronchoscopes can be within reach of the surgeon until the full time-out is completed” (they have an online version to fill out too). A bunch of “secret shoppers” has also been set up to audit compliance. While I know nothing about surgery, I am a big fan of the simple process of checklists and how they can help improve even the most difficult of procedures…

Surgery checklist

… such as systematic searches. Go on, introduce one into your own working day!