Results of a large VA study appearing in the Journal of the American Medical Association show that creating and discussing checklists – and getting patient feedback – prior to a surgical procedure can help save lives. The Associated Press reports:
Surgery deaths dropped 18 percent on average over three years in the 74 VA hospitals that used the strategy during the study. Surgery team members all created checklists and discussed them in briefings before, during and after surgery. That’s a somewhat novel concept in a setting where the surgeon has traditionally called all the shots…
The VA’s program began in 2003 and over time has been adopted at virtually all of its 130 surgery centers. Before sedation, patients identify themselves and the reason for their surgery, hear the checklists being read off, and can speak up if something doesn’t sound right. The idea is to give everyone in the operating room an equal voice in helping ensure patient safety.
Other studies have shown the effectiveness of surgical safety checklists, and thousands of hospitals now regularly use checklists. (Stanford Hospital was actually one of the first to adopt the approach.) But as described in a JAMA editorial (subscription required), this study was as much about teamwork as the checklist:
[The intervention in this study] included building teamwork skills through training and coaching, and providing tools to support teamwork. The authors developed evidence-based training yet appropriately encouraged local adaption. Teams did not solely check off items on the checklist, they used the checklist to trigger a conversation.
The editorial goes on to say that these findings demonstrate the importance of making good teamwork in medical settings “the norm rather than the exception.”