Hospitals Developing Checklists to Reduce Mistakes

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Does patient have a known allergy? Difficult airway risk? Risk of blood loss?

Those are some of the questions on a global Surgical Safety Checklist, part of an increasing trend that the local hospital trade group is trying to spread. The Greater New York Hospital Association wants its members to adopt a program of relatively simple checklists, which has been proven to reduce medical error.

"Getting it used and in place properly is not easy or straightforward, but our clinical staff has really embraced this," said Dr. Ross Wilson, who has helped develop one such program for the city’s public hospital system.

Wilson said there's increasing evidence that checklists can reduce infections and other complications by making sure medical teams always keep basic, high-priority items in mind.

"They're able to summarize very complex, large amounts of information in a very short fashion," he said. "That's why they took root in fields like aviation, and that's where they’ve come to health care from in the last five or six years."

A 2009 study in the New England Journal of Medicine found the average surgical complication rate dropped from 11 percent to 7 percent when checklists were used.

The public hospital checklists tend to have five or six items for each of three "pause points" during a procedure – adding up to 15 to 20 items in all.

Wilson, the Health and Hospitals Corporation's chief medical officer, helped initiate the HHC surgical checklist program 18 months ago. HHC is currently analyzing data to see if its actually reducing errors.

Wilson will help advise other local hospitals – and will invite surgeons and others from hospitals across the city to come into HHC facilities to observe.