Recent research suggests using two surgical checklists together may result in fewer medical errors and less harm to patients.
Checklists are an important part of patient safety. In a surgical setting, careful attention to checklists can reduce serious mistakes, like wrong-site or wrong person surgeries. We recently talked about the importance of the surgical time-out that is part of the checklist process. Overall, checklists draw attention to surgical detail and aim to improve surgical team function and culture.
In 2013, the rate of medical error in the United States was placed at approximately 400,000 deaths per year—and that was seven years ago. The rate continues to rise as do efforts to stem the very human mistakes that lead to injury and death caused by medical negligence. Checklists are part of that effort. Two widely used surgical checklists include the World Health Organization surgical safety checklist (WHO SSC) and the Surgical Patient Safety System checklist (SURPASS).
While you might think two checklists are a bit much, they do not primarily overlap. Here are some differences:
- SURPASS: The SURPASS list ensures that admission concerns leading up to surgery including radiology, lab work, blood products, and medications are accounted for by individuals responsible for that work.
This list picks up in the Recovery room, the intensive care unit, or wherever the patient bed is located. Instructions about medications, post-surgical care, and follow-up are maintained until the patient is discharged. At that time, the SURPASS checklist aids caregivers in discharging the patient appropriately with needed medications and instruction.
- WHO SSC: The WHO list carefully lists procedures that should occur prior to anesthesia, prior to incision and after the procedure, before the patient is taken from the operating room. The WHO SC list brings focus to the role and responsibility of individual team members throughout the surgical experience.
Surprisingly, the two checklists are not used jointly. Not surprisingly, a recent study published in JAMA surgery found significant benefits to the use of the two checklists together. Looking at data from approximately 9,000 surgical procedures in three hospitals, the primary benefits of using both checklists include:
- Fewer surgical complications
- Drop in the number of surgeries repeated
- Reduced rate in hospital readmissions
To answer the question posed by the headline—more surgical checklists, fewer errors? When used correctly, the answer from this research appears to be “yes.”
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