August 21, 2013 10:23 — 2 Comments
Researchers: Checklist is No Magic Bullet in Patient Safety
A study conducted by two researchers from the University of Oxford and the University of Leicester suggests that the use of a checklist as a patient safety measure may not be as effective in curbing “never events” as originally thought. In assessing operating room procedures in the United Kingdom and Africa, researchers discovered that many surgical teams were reluctant to use the checklist, noting that the attitudes of senior team members undermined the use of the checklist at all – checklists that are used to encourage teamwork and reduce hierarchies.
“The principles underlying the surgical checklist are good ones, but only now are we waking up to the serious challenges associated with implementation. On its own, the checklist is no magic bullet,” one researcher said. Click here to read the full story.
This is because the checklist needs to be part of a broader change initiative. The Comprehensive Unit-based Safety Program (CUSP) that first reported on using a checklist to reduce central line associated bloodstream infections explicitly links technical improvement work (like creating checklists) with adaptive improvement work (the sociocultural change piece). One without the other won’t work in a sustainable way.
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Checklists are new to most institutions and OR environments. Prevailing cultures may cause reluctance to use checklists, but I would predict that these tools will withstand the test of time. It is naive to expect a single intervention such as checklists to bring about a substantial change. As Jeffrey noted above, the broad cultural change will eventually produce measurable improvements in patient safety. Checklists serve as a daily reminder to the entire OR team of the commitment to patient safety.
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