Checklist
In 2009, a major study by the World Health Organization (WHO) in conjunction with the Harvard School of Public Health was published in The New England Journal of Medicine. This study demonstrated significant improvement in surgical complications and mortality with the implementation of a simple checklist (Table) used preoperatively, perioperatively, and postoperatively 1).
A large study was published in The New England Journal of Medicine examining the effect of surgical checklist implementation in Ontario, Canada 2).
A checklist in the operating room ensures that everything needed for an operation has been considered in advance. Similarly, we also have checklists for clinical research to ensure that the people who conducted the clinical research really covered everything needed for a successful study 3).
Morbidity due to avoidable medical errors is a crippling reality intrinsic to health care. In particular, iatrogenic surgical errors lead to significant morbidity, decreased quality of life, and attendant costs. In recent decades there has been an increased focus on health care quality improvement, with a concomitant focus on mitigating avoidable medical errors. The most notable tool developed to this end is the surgical checklist. Checklists have been implemented in various operating rooms internationally, with overwhelmingly positive results. Comparatively, the field of neurosurgery has only minimally addressed the utility of checklists as a health care improvement measure. Literature on the use of checklists in this field has been sparse. Considering the widespread efficacy of this tool in other fields, the authors seek to raise neurosurgical awareness regarding checklists by reviewing the current literature 4).
Patient safety is foundational to neurosurgical care. Post-procedural “debrief” checklists have been proposed to improve patient safety, but there is limited data about their use in neurosurgery.
Magill et al. implemented an initiative to routinely perform post-operative debriefs and evaluated the impact of debriefing on operating room (OR) safety culture 5).