Safety checklists help pilots navigate takeoffs and landings, keep military operations on track and prevent nuclear power plants from melting down.
Now, checklists are moving to operating rooms.
Spurred on by impressive drops in post-surgical problems among adult patients, Lucile Packard Children's Hospital at Stanford is teaming up with 13 other U.S. pediatric hospitals to test whether simple pre- and post-surgical checklists can keep kids safer in the OR.
"We've seen proof that a surgical checklist works really well in adults," said Sandra Trotter, the manager for patient safety at Packard Children's. "But we want to make sure the checklist is adapted appropriately to children, and thoroughly studied in a pediatric setting." For instance, the adult checklist was changed to add a step to verify each patient's weight, since pediatric medications are dosed by weight, Trotter said.
The checklists are designed to be administered in three phases. During two pre-surgery phases, the surgical team performs key steps like verifying the patient's identity and making sure they have all the equipment, images and lab results they'll need. After surgery, the team discusses concerns from the procedure and for the post-operative period.
"Having a team responsibility for completing the checklist serves as a final check that you really have everything in place," Trotter said. "It's like pilots checking all their instrument gauges. You are standardizing the essential steps and making sure they happen every time."
As surgeon, writer and Stanford alumnus Atul Gawande, MD, reported in the New Yorker, checklists have already revolutionized safety in intensive care units. It'll be exciting to see what they can achieve in pediatric operating rooms.
