Comments on: Does a checklist before surgery really save lives? http://www.kevinmd.com/blog/2009/01/does-checklist-before-surgery-really.html Tue, 14 Feb 2012 23:00:00 +0000 hourly 1 By: DocInKYhttp://www.kevinmd.com/blog/2009/01/does-checklist-before-surgery-really.html#comment-89242 DocInKY Fri, 16 Jan 2009 15:02:00 +0000 http://clients.emmense.com/kevinmd/2009/01/does-a-checklist-before-surgery-really-save-lives.html#comment-89242 I looked at the 'checklist' from the article. At our hospital we do all but "introduce ourselves" and discuss "critical and unexpected steps". That step could actually be a full hour of lecture and debate in my specialty for some cases (PV surgery) Do I need to create a sub checklist for every case type I do for that step?<br/><br/>I believe due to the actions of the Joint Commission, the vast majority of hospitals already do the majority of this "checklist" I think the gains seen in the study are from the international centers that do not have the pluses (and minuses) of TOFKAJACHO!<br/><br/>DocInKY I looked at the ‘checklist’ from the article. At our hospital we do all but “introduce ourselves” and discuss “critical and unexpected steps”. That step could actually be a full hour of lecture and debate in my specialty for some cases (PV surgery) Do I need to create a sub checklist for every case type I do for that step?

I believe due to the actions of the Joint Commission, the vast majority of hospitals already do the majority of this “checklist” I think the gains seen in the study are from the international centers that do not have the pluses (and minuses) of TOFKAJACHO!

DocInKY

]]> By: Anonymoushttp://www.kevinmd.com/blog/2009/01/does-checklist-before-surgery-really.html#comment-89240 Anonymous Fri, 16 Jan 2009 13:27:00 +0000 http://clients.emmense.com/kevinmd/2009/01/does-a-checklist-before-surgery-really-save-lives.html#comment-89240 It has been proven to work in other areas, and this isn't the first study showing benefit in medicine. As a physician, I used to buy into the egocentric myth that doctors were different. Even Kings on a throne sit on their asses like everyone else. <br/><br/>Our brains are no different, we are prone to the same errors, and can use some of the same ideas to minimize them. <br/><br/>Several years ago I started using a simple checklist with outpatients. The same one I used mentally, but the mind slips at time, especially when distracted by curve balls and smoke and mirror acts. It helps.<br/><br/>I also fly. I memorize the checklists that I use perform the items and then check against the list for performance--often something was forgotten!<br/><br/>Checklists don't work when people don't take it seriously. They will tend to fake it, go through the motions. The last instrument in the belly case I saw, the instrument count was checked off. I have personally seen 220# surgeons rant and snort at trembling 22 year old nurses while they recheck the sponge the count which is incorrect. It is probably good that I was more of a coward when I was young because I don't think I could watch that today with giving the bastard the ass kicking he deserved upon exiting the OR. It has been proven to work in other areas, and this isn’t the first study showing benefit in medicine. As a physician, I used to buy into the egocentric myth that doctors were different. Even Kings on a throne sit on their asses like everyone else.

Our brains are no different, we are prone to the same errors, and can use some of the same ideas to minimize them.

Several years ago I started using a simple checklist with outpatients. The same one I used mentally, but the mind slips at time, especially when distracted by curve balls and smoke and mirror acts. It helps.

I also fly. I memorize the checklists that I use perform the items and then check against the list for performance–often something was forgotten!

Checklists don’t work when people don’t take it seriously. They will tend to fake it, go through the motions. The last instrument in the belly case I saw, the instrument count was checked off. I have personally seen 220# surgeons rant and snort at trembling 22 year old nurses while they recheck the sponge the count which is incorrect. It is probably good that I was more of a coward when I was young because I don’t think I could watch that today with giving the bastard the ass kicking he deserved upon exiting the OR.

]]> By: Anonymoushttp://www.kevinmd.com/blog/2009/01/does-checklist-before-surgery-really.html#comment-89232 Anonymous Fri, 16 Jan 2009 00:19:00 +0000 http://clients.emmense.com/kevinmd/2009/01/does-a-checklist-before-surgery-really-save-lives.html#comment-89232 It's startling to know that the folks in the OR introducing themselves to one another is an item. <br/><br/>Perhaps addressing one another as "hey you" isn't conducive to productivity and safety. It’s startling to know that the folks in the OR introducing themselves to one another is an item.

Perhaps addressing one another as “hey you” isn’t conducive to productivity and safety.

]]> By: Mike O'Mearahttp://www.kevinmd.com/blog/2009/01/does-checklist-before-surgery-really.html#comment-89229 Mike O'Meara Thu, 15 Jan 2009 22:15:00 +0000 http://clients.emmense.com/kevinmd/2009/01/does-a-checklist-before-surgery-really-save-lives.html#comment-89229 At one time, pilots thought they didn't need a checklist to fly a plane, now the US is in 3rd year of no airline fatalities.<br/><br/>This article is also good reading. "Medicine today has entered its B-17 phase" http://is.gd/2svs At one time, pilots thought they didn’t need a checklist to fly a plane, now the US is in 3rd year of no airline fatalities.

This article is also good reading. “Medicine today has entered its B-17 phase” http://is.gd/2svs

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