Medical care is an extremely complex enterprise. From start to finish, it requires the proper coordination of a very large number of different skills, procedures, and events. For example, in a surgery, scrub nurses, circulating nurses, techs, surgeons, and an anesthesiologist must all coordinate their care. The list of procedures that must be completed to properly execute a surgery is endless, and they include the mundane – what antiseptic should be used – to the tragic – what is the plan in the event the patient codes on the table. If any one of the important steps of a surgery is not done correctly, even the mundane, the patient can suffer a horrific injury.
The problem is that the complexity of even the most routine surgeries is beyond the computing power of even the smartest. If medical providers relied on their memory alone, there are simply too many tasks to remember for a surgeon and their crew to execute reliably.
This is where checklists have become essential to patient safety in the delivery room. Study after study, and the book, The Checklist Manifesto: How to Get Things Right, have shown that checklists are effective to prevent operating staff's from missing key steps and potentially fatal errors, such as operating on the wrong organ. Checklists have built in pause points where members of the surgical team are required to make conscious decisions. At these points, the members of the surgical team are reminded of the necessary steps they need to take, and the order they need to take them. These checklists force doctors and nurses to slow down and consciously pay attention to the steps they need to keep the patient safe. If used consistently, checklists save lives and prevent harmful injuries to patients.
Importantly, the medical staff must wholeheartedly adopt the checklists for it to be effective. A checklist that is not strictly adhered to can be more dangerous than none at all. One way to do this is to have the medical staff themselves create the checklists, so they are invested in its success.
Also, each person of the medical team must be empowered to speak up if they have concerns about patient safety. This is built into the checklists by requiring nurses to say their name and mention concerns they have at the beginning of the case.
When we investigate our client's medical injuries, we often find that basic steps were not taken. In the modern world of rushed, complex medical care, checklists can be a very important tool to ensure patient safety.