Checklists Up Performance in Operating-Room Crises

Failure to adhere to lifesaving processes of care less common in simulations when checklists are used

WEDNESDAY, Jan. 16 (HealthDay News) -- Using checklists during operating-room crises can improve surgical care, according to a study published in the Jan. 17 issue of the New England Journal of Medicine.

To assess a tool to improve adherence to evidence-based best practices during operating-room crises, Alexander F. Arriaga, M.D., M.P.H., Sc.D., from the Harvard School of Public Health in Boston, and colleagues randomly assigned 17 operating teams to manage half of 106 simulated surgical-crisis scenarios with a set of crisis checklists and the remaining scenarios from memory alone.

The researchers found that, during simulations, when checklists were available, failure to adhere to lifesaving processes of care was significantly less common (6 percent of steps missed when checklists were available versus 23 percent when they were not available). When adjusting for clustering within teams as well as institution, scenario, and learning and fatigue effects, the results were similar (adjusted relative risk, 0.28). The performance improvement with the checklist was seen for every team. If one of these crises occurred while a participant was undergoing an operation, 97 percent reported that they would want the checklist used.

"Our study shows a significant and substantial value in the use of carefully designed crisis checklists for the operating room," the authors write.

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