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Using Checklists as a Tool for Reducing Medical Errors

Using Checklists as a Tool for Reducing Medical Errors

Tuesday, August 10th, 2010

Medical care checklists have been in use for a decade now, with mixed success. In his 2009 book The Checklist Manifesto, author Atul Gawande examines the checklist and its role in improving outcomes. Gawande, a surgeon and journalist who writes for Slate and the New Yorker, suggests that physicians, nurses and all health care providers should be mindful of how their specific duties fit into the increasingly complex business of health care.

The Checklist Manifesto distinguishes “errors of ignorance” (mistakes made by people who do not actually have the knowledge required to make a particular decision) from so-called “errors of ineptitude” (those resulting from misguided decision-making in the heat of the moment). Checklists are a way to combat both types of errors leading to medical malpractice.

Though Gawande trumpets checklists as a way to “get things right,” he does stress that creating a checklist without further effort will not solve problems. He argues that health care providers must not only implement a checklist system, but understand why the system is necessary. Mistakes in health care are inevitable, but by staying cognizant of the errors commonly committed in the medical field, and by being willing to change, mistakes can be prevented and injuries reduced.

Checklists are particularly useful to prevent errors of ineptitude, giving everyone from the world’s brightest surgeon to a first-year nursing assistant a straightforward list of tasks that must be dealt with in complex and stressful situations. Creating the checklist in itself is part of the education – you must examine the entire process with a fine-toothed comb, breaking it down into its component parts in order to make the checklist as helpful as possible.

These checklists are at their most useful in a patient-centered environment where teams work collaboratively. These are environments where nurses feel safe to speak up if the surgeon did not follow proper checklist protocol. Checklists are only a tool (with only the potential to be very effective) to combat medical negligence and preventable malpractice, but a checklist’s effectiveness is directly related to the willingness of team members to allow feedback, accept flaws and not let egos get in the way. In the right hands, the checklist can help hospitals in the fight to keep their patients’ best interests at hand.

The changes suggested by Gawande and Pronovost will bring great benefit to health care but will take time and effort to implement. And no system is one-hundred percent perfect. If you or a loved one has been injured by the malpractice or negligence of a medical provider, consult a personal injury attorney to learn more about your rights and options.
Category: Medical Malpractice
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