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Use of Checklists to Reduce Surgical Errors Must Become Standard Operating Procedure

For years, thoughtful people within the medical profession have advocated for the use of checklists to prevent surgical errors. Passionate advocates for greater use of checklists include Atul Gawande, the Boston surgeon and New Yorker contributor, and Dr. Peter Pronovost of Johns Hopkins.

But hospitals have been slow to adopt the systematic use of checklists to make sure hands are washed, the right body part is being operated on, and so on.

Could it be that the reluctance to use checklists, or outright resistance to them, is starting to disperse?

The Greater New York Hospital Association is encouraging its members to adopt a basic checklist program. The goal is to introduce "pause points" into the process, so that patient safety is always kept in mind. A basic checklist will have five or 6 items, to be verified at three different pause points.

Of course, instituting even a basic program is not as simple as it seems. Medical culture has historically been averse to the more open communication between doctors, nurses, and other staff that the use of checklists promotes. Under the old way of doing things, the word of the surgeon is often unquestioned. Nurses and other staff often do not feel free to question it, even if they believe something is wrong.

So the announcement of an intention by a hospital system to increase the use of surgical checklist is welcome. But two points must be made. For one thing, even when a program is in place, it must be followed - not merely given lip service.

In addition, even if a checklist is used, the medical team can still make errors. Talk with us in a confidential consultation if you or someone in your family has been injured by a medical mistake.

Source: "Hospitals Developing Checklists to Reduce Mistakes," WNYC News, 5-3-11

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