How to Design a Surgical Checklist for Patient Safety

How to Design a Surgical Checklist for Patient Safety

By Roxanne Blanford

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Checklists have long been an established part of complex industries ranging from medicine, aviation, and space flight, to marine travel and nuclear facilities. In the healthcare field, lives are put at risk constantly due to medical mistakes commonly associated with simple human error.

Fortunately, surgical checklists have demonstrated the capacity to improve patient safety.  Compliance with procedural guidelines can reduce error, improve team communication and decrease the odds for adverse outcomes by minimizing incidences of patient harm.

Speak Up for Surgical Checklists

Design, customization and proper implementation are all key to successful checklist utilization. Therefore, it is helpful to know how to make an effective one.

A checklist should, first and foremost, be unique to an organization's circumstance, needs, and policies. A safety checklist should be customized for the specific organization (down to its logo and colors), so that it 'feels' more like a natural integration and less like an intrusion.

Here are just a few more tips for creating a medical checklist for patient safety.

1. Have a clear objective for the checklist
What is the purpose for the list? Is the checklist intended to prevent patient harm, to confirm proper procedure or address other issues? A simple verification checklist item, such as “Has the patient confirmed his/her identity, surgical site, procedure, and consent?” can help surgeons avoid wrong-site surgery. Verification can save lives.

2. Implement a streamlined system for checklist verification
With a checklist, all team members are responsible for adhering to protocol.  To streamline the process, have one person in charge of checking off items and, perhaps, someone else in charge of verification. This way, the surgical team will have double confirmation for when each item is checked off, followed through and verified. Ultimately, this will provide evidence that proper safety procedures were implemented.

3. Keep it short and relevant
It's important for the list to be clearly understood by the entire team. For this reason, keep the checklist concise and well-organized. It should be thorough and focused on the most important tasks, yet it should also be simple. Do not make it so intricately complicated that it becomes a nuisance to use or a hindrance to good patient care. 

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*Checklist courtesy of the Association of periOperative Registered Nurses, with safety checks outlined by the World Health Organization (WHO) and The Joint Commission Universal Protocol. It is designed for use in all types of facilities (eg, hospital ORs, ambulatory surgery settings, physician offices).    

HuangLC ; Conley D ; Edmondson L ; Berry WR ; Singer SJ.; et al. The surgical safety checklist and teamwork coaching tools: a study of inter-rater reliability. BMJ Qual Saf. 2014; 23: 639-650