Strategies for Improving Surgical Quality — Checklists and Beyond

Long standard in the safety-conscious aviation industry, checklists are now being promoted aggressively in the medical literature and popular press. 1 – 3 Almost all U.S. hospitals mandate simple preoperative “time-outs” to minimize the risk of egregious mistakes, such as operating on the wrong site or the wrong patient. Recently, however, many hospitals have started implementing more comprehensive checklist procedures for the operating room, aimed at increasing compliance with practices known to reduce complications and enhancing teamwork. Last year, a large international study supported by the World Health Organization (WHO) reported that such checklists cut surgical morbidity and mortality almost in half. . . .