Barriers to implementing the World Health Organization’s Trauma Care Checklist

Abstract

Therapeutic/care management, level V.

Lost information during the handover of critically injured trauma patients: a mixed-methods study

“…Thought leaders in the patient safety field have also called for caution in viewing checklists as a panacea for rectifying errors in communication and threats to patient safety 35 36. In fact, since the completion of this study, a trauma care checklist has been piloted in our institution, with significant barrier to use and implementation, due to challenges similar to those highlighted in this study 37. Solutions proposed by our participants included the need for member and leader identification, with a unified, multidisciplinary handover (possibly involving a checklist) with mutual understanding of cross-unit cultures.…”

A survey to identify barriers of implementing an antibiotic checklist

“…We identified the barriers before implementation of the checklist, and the physicians, therefore, may have felt that they still had an influence on the contents and design of the checklist. Finally, it appears that the benefit of the use of checklists is not always clear [17][18][19] and a lack of understanding of the purpose of the checklist might influence its use [17]. This topic was, however, not mentioned as a barrier in our study.…”

“…The explanation for why this is a top five barrier in our survey and not in previous studies might be that other barrier studies have been done during or after checklist implementation. In that phase, the physicians' main concerns are the organisational problems they are facing in daily practice and, consequently, these studies mainly describe logistic barriers, such as difficulties in timing (when to fill out the checklist) and lack of time [16-19, 21, 24], and professional barriers such as lack of senior support and professional hierarchy [17,18,20,24]. We identified the barriers before implementation of the checklist, and the physicians, therefore, may have felt that they still had an influence on the contents and design of the checklist.…”

“…Barrier studies performed during or after checklist implementation [16][17][18][19][20][21][22][23][24] described barriers such as lack of understanding the purpose of the checklist [17], duplication with current work [18,19] and problems with the method of implementation [24].…”

“…Box 2 shows the terms we used in our search, which resulted in 168 hits in total. We selected one book [25], three systematic reviews [12,26,27], eight relevant barrier studies [15][16][17][18][19][20][21][22]24] and four studies on barriers to the appropriate use of antibiotics [28][29][30][31]. Based on this information, we adapted the MIDI to fit the topic of antibiotic use, so we removed potential barriers that were not relevant and added barriers that were mentioned in the literature.…”