Surgical checklists reduce errors, save lives

Studies of shown that hospitals requiring use of surgical safety checklists have better outcomes than those who don’t.

Perhaps the best thing about a checklist is the prevents monotony and routine from setting in and allowing mistakes.

My family recently stay at the Waldorf Astoria Hotel near Disney World, in Orlando, Florida. It’s a beautiful property with excellent service. As I checked in at the front desk, I wasn’t surprised to see a detailed checklist on the other side of the desk by the representative’s computer. It’s clear that someone thought through the type of experience that the Waldorf wants its customers to have. But putting it in writing for the staff to follow every day brings accountability and results.

The airline industry also is big on checklists. For the thousands of flights taking off every day all over America, it’s standard practice for the pilots to run through a checklist and inspection before each and every flight.

Over the past 20 years, checklists have started to become adopted in healthcare. Safety and accrediting organizations such as the World Health Organization (WHO) and The Joint Commission (JCAHO) have published their own versions. They have unique perspectives from the wide body of data and reports they receive from hospitals, which allowed them to identify common mistakes that could be avoided with checklists.

One of most fertile grounds for healthcare mistakes is the operating room. Wrong site surgeries, wrong patient surgeries, and retained surgical items (foreign bodies) are just a few of the bad things that aren’t supposed to ever happen but continue to occur on a regular basis.

Beyond avoiding these types of complications, though, a recent study out of South Carolina shows that surgical checklists can be a matter of life and death. That state’s Safe Surgery 2015 initiative found that there was a 22% reduction in post-surgical deaths in hospitals that completed the statewide surgical checklist program. That works out to saving around 500 lives each year in the Palmetto State alone.

In the South Carolina program, participating hospitals placed large poster-size checklists in each operating room. When the whole operating room team is present—surgeons, anesthesiologists, certified registered nurse anesthetist (CRNAs), registered nurses, surgical techs, and others—everyone is supposed to stop, turn and look at the poster, and go over each item on the list aloud with everyone participating.

Topics on the checklist include verifying the patient name and date of birth, allergies, surgery type and location, that necessary equipment is in the room, the type of anesthesia being used, that there are no existing airway issues, and how long the surgery is supposed to last. At the conclusion of the group discussion, there’s an opportunity for questions.

While the WHO and Joint Commission checklists vary in what’s included, the basics are the same. It’s important that every surgery is done on the same patient in the same site, with the operating team aware of known risks and prepared with any medications or equipment that may be needed.

At the conclusion of surgery, it’s a good idea to continue the checklist process. WHO recommends, for example, that a nurse verbally confirm with the operating room team the name of the procedure that occurred; that there’s a correct count of instruments, sponges, and needles (no foreign body was left inside the patient); how any specimens are labeled for being sent to the laboratory or pathology; whether there any equipment issues to be repaired; and any key post-operative recovery issues that need to be identified.

If you’ve been seriously injured because of poor operating room or surgical care in Texas, then contact an experienced, top-rated and rated Houston, Texas medical malpractice lawyer for a complimentary evaluation of your potential case.

Robert Painter
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Robert Painter

Robert Painter is an award-winning medical malpractice attorney at Painter Law Firm Medical Malpractice Attorneys in Houston, Texas. He is a former hospital administrator who represents patients and family members in medical negligence and wrongful death lawsuits all over Texas. Contact him for a free consultation and strategy session by calling 281-580-8800 or emailing him right now.