A checklist created by the WHO helped reduce complications in surgery by ensuring critical steps were not missed. While many hospitals already had standard operating procedures, checklists improved consistency by making sure antibiotics and blood were available. Properly designed checklists are collaborative, focused, brief, and actionable. Implementing WHO's 19-step checklist led to a 40% reduction in death and 33% reduction in complications across various hospitals globally. Checklists can help in meetings, file sharing, and testing by preventing important steps from being overlooked.
2. How NOT to Complete Checklist
The World Health Organization wanted to find a very inexpensive way to reduce the
number of after-surgery complications by making sure blood was available and
antibiotics were there.
Almost all of the steps in the checklist created by the WHO were contained in
existing SOPs, but 1/3 of the time at least one step was missed.
A checklist has two purposes: ensuring consistency and introducing (or maintaining)
a culture that values achieving it.
4. Your Checklist Is:
• Focused: Strive to be concise, addressing those issues that
are most critical.
• Brief: It should take no more than a minute to complete each
section of the checklist. Five to nine items in each Checklist
section are ideal.
• Actionable: Every item on the Checklist must be linked to a
specific, unambiguous action.
5. How to Complete Checklist
19 Steps that resulted in 40% decrease in rate of death after surgery and
1/3 decrease in complications after surgery over the test period.
The study took place in eight hospitals from Seattle, WA to Tanzania.
From the most cutting edge to the poorest, every hospital reported an
improvement.
6. Yes all of this is great, but I just don’t
want to because…
Reasons:
• I know my job, I don’t need it
• Too many steps to document, either you know it or you don’t
• Just another procedure, no value
• Don’t have the time
7. Where Can a Checklist Help You?
• Meetings – Incorporate them into your agenda to ensure
important steps are not missed.
• Sending files – Are they in the right format? Encrypted? What is
most important to check?
• Testing – How are breaks communicated? Are you checking
more than one user access? How do you decide testing is done?
Editor's Notes
W.H.O. wanted to find a very inexpensive way to reduce the number of after-surgery complications by making sure blood was available and antibiotics were there.
Make sure the people who need to use it can get to it. To ensure the message got across, the W.H.O. team created YouTube videos, documents that allowed hospitals to make the changes to the checklist that fit their environments, and an app!
Five to nine items in each Checklist section are ideal.
Answers:
I know my job, I don’t need it – Created with the understanding the user knows what is to be done, just double-checks important steps have been completed.
Too many steps to document, either you know it or you don’t – Best practice is to only have only 5-9 most critical issues in each section.
Just another procedure, no value – Knowledge your most critical steps have been completed is valuable.
Don’t have the time – Should take about a minute to read off.
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Surgeons
78% wanted to continue keep using the WHO checklist.
93% said they would want the checklist used if they were
having surgery done.