Standard Written Checklists Can Improve Patient Safety During Surgical Crises
Examples of simulated surgical emergencies used in the study were air embolism (gas bubbles in the bloodstream), severe allergic reaction, irregular heart rhythms associated with bleeding, or an unexplained drop in blood pressure.
Each surgical team consisted of anesthesia staff, operating room nurses, surgical technologists and a mock surgeon or practicing surgeon.
"For decades, we in surgery have believed that surgical crisis situations are too complex for simple checklists to be helpful. This work shows that assumption is wrong," said Atul Gawande, M.D., senior author of the paper, a surgeon at Brigham and Women's Hospital and professor at the Harvard School of Public Health. "Four years ago, we showed that completing a routine checklist before surgery can substantially reduce the likelihood of a major complication. This new work shows that use of a set of carefully crafted checklists during an operating room crisis also has the potential to markedly improve care and safety."
Hospital staff who participated in the study said the checklists were easy to use, helped them feel more prepared, and that they would use the checklists during actual surgical emergencies. In addition, 97 percent of participants said they would want checklists to be used for them if a crisis occurred during their own surgery.The practice of using checklists is borrowed from high-risk industries such as aviation and nuclear power, where checklists have been tested in simulated settings and shown to improve performance during unpredictable crisis events. SOURCE Agency for Healthcare Research and Quality
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