Back to basics: checklists in aviation and healthcare

Clay‐Williams, Robyn; Colligan, Lacey

doi:10.1136/bmjqs-2015-003957

Cited by 154 publications

(111 citation statements)

References 17 publications

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“…Checklists have been used effectively as part of routine safety procedures [6]. The introduction of the Safer Surgery Checklist [7] required operating theatre teams in 2009 to change their behaviour in team readiness and has been credited with the reduction of post-operative complications and mortality [8].…”

Section: Introductionmentioning

confidence: 99%

Crisis checklists for in-hospital emergencies: expert consensus, simulation testing and recommendations for a template determined by a multi-institutional and multi-disciplinary learning collaborative

Kellett

Barach

Chaloner

et al. 2017

BMC Health Serv Res

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Background‘Failure to rescue’ of hospitalized patients with deteriorating physiology on general wards is caused by a complex array of organisational, technical and cultural failures including a lack of standardized team and individual expected responses and actions. The aim of this study using a learning collaborative method was to develop consensus recomendations on the utility and effectiveness of checklists as training and operational tools to assist in improving the skills of general ward staff on the effective rescue of patients with abnormal physiology.MethodsA scoping study of the literature was followed by a multi-institutional and multi-disciplinary international learning collaborative. We sought to achieve a consensus on procedures and clinical simulation technology to determine the requirements, develop and test a safe using a checklist template that is rapidly accessible to assist in emergency management of common events for general ward use.ResultsSafety considerations about deteriorating patients were agreed upon and summarized. A consensus was achieved among an international group of experts on currently available checklist formats performing poorly in simulation testing as first responders in general ward clinical crises. The Crisis Checklist Collaborative ratified a consensus template for a general ward checklist that provides a list of issues for first responders to address (i.e. ‘Check In’), a list of prompts regarding common omissions (i.e. ‘Stop & Think’), and, a list of items required for the safe “handover” of patients that remain on the general ward (i.e. ‘Check Out’). Simulation usability assessment of the template demonstrated feasibility for clinical management of deteriorating patients.ConclusionsEmergency checklists custom-designed for general ward patients have the potential to guide the treatment speed and reliability of responses for emergency management of patients with abnormal physiology while minimizing the risk of adverse events. Interventional trials are needed.

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Section: Introductionmentioning

confidence: 99%

Crisis checklists for in-hospital emergencies: expert consensus, simulation testing and recommendations for a template determined by a multi-institutional and multi-disciplinary learning collaborative

Kellett

Barach

Chaloner

et al. 2017

BMC Health Serv Res

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“…Despite the widespread use of standard evaluation and management protocols, compliance with performing critical tasks during patient evaluation is low [11]. To assist with memory recall of procedural items in settings with high cognitive load, clinicians have used mnemonics when designing protocols (e.g., “ABC” for “Airway, Breathing, Circulation” in resuscitation), but even these strategies are prone to error [5]. Drawing from experiences with checklists in other safety-critical domains such as aviation, researchers have designed a trauma resuscitation checklist as an alternative approach to improving team performance [14].…”

Section: Introductionmentioning

confidence: 99%

Design Challenges in Converting a Paper Checklist to Digital Format for Dynamic Medical Settings

Sarcevic¹,

Rosen²,

Kulp³

et al. 2016

Proceedings of the 10th EAI International Conference on Pervasive Computing Technologies for Healthcare

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We describe a mobile digital checklist that we designed and developed for trauma resuscitation-a dynamic, fast-paced medical process of treating severely injured patients. The checklist design was informed by our analysis of user interactions with a paper checklist that was introduced to improve team performance during resuscitations. The design process followed an iterative approach and involved several medical experts. We discuss design challenges in converting a paper checklist to its digital counterpart, as well as our approaches for addressing those challenges. While we show that using a digital checklist during a fast-paced medical event is feasible, we also recognize several design constraints, including limited display size, difficulties in entering notes about the medical process and patient, and difficulties in replicating user experience with paper checklists.

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“…Indeed, successes3 and failures4–6 illustrate an underlying difficulty with understanding precisely why checklists work in some cases but not in others. A recent viewpoint summarises the varying applications of checklists in aviation and healthcare, reflecting upon the dangers of making assumptions about their ‘ubiquitous utility’ 7. This provided a timely “The Problem with…”8 opportunity, in which we consider the narratives that often surround the challenges faced in designing and implementing a successful checklist, and the science used to explore it.…”

mentioning

confidence: 99%