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Surgical Checklists Prevent Deadly Medical Mistakes

January 17, 2011

There are a few areas in which both the medical profession and legal profession agree. Reducing the number of preventable medical mistakes is surely one of them. According to a recent study conducted in the Netherlands, a simple surgical checklist can prevent one third of medical mistakes that result in medical malpractice lawsuits. Many of these lawsuits involve patients who have died from surgical errors. Thus, surgical checklists not only reduce the number of medical negligence suits, they save lives.

A surgical checklist entails a number of precautions, including making a correct operation schedule, checking availability of equipment, and marking the body part where the procedure should be performed. The concept of a pre-surgery checklist is similar to the pre-flight checklist that a pilot utilizes before take off. In both cases, preventing errors begins with a pre-determined list of items that must be verified before proceeding through each step.

Commenting on the study, Dr. Eefje de Vries of the Academic Medical Centre of Amsterdam said "while the checklist as a whole may seem a little intimidating, the separate parts for each stage of the surgical pathway take little time to complete." Dr. Vries' team discovered that 29% of medical malpractice lawsuits can be avoided through implementing this type of checklist, in addition to proper communication between patients and the medical staff. This will likely prevent "a considerable amount of damage, both physical and financial," researchers say.

The Netherlands' study is not the first to demonstrate the multiple healthcare benefits of following a surgical checklist. Commenting on the Netherlands' study, Harvard surgeon Dr. Atu Gawande said "[t]his kind of evidence indicates that surgeons who do not use one of these checklists are endangering patients." Dr. Gawandee of the Harvard School of Public Health has written extensively on the topic of preventing surgical errors (and medical malpractice cases) with a surgical checklist.

The Joint Commission, which operates accredited programs to hospitals and other health organizations, found 116 reported wrong-site surgical errors in 2008. Wrong site surgical mistakes are operations performed on the wrong side of the patient, the wrong organ, or on the wrong patient. To reduce these preventable surgical errors, the Joint Commission has also advocated the benefits of surgical checklists. The Joint Commission has offered a three-part protocol to prevent surgical errors. The first component requires the healthcare team to ensure all of the patient' relevant documents and surgical equipment is available, correctly identified, and reviewed before surgery. The second element requires marking the surgical site (with a marker) before surgery. The third and final component calls for a "time out" before surgery begins for the healthcare team to verify the patient' identify, the surgical site, and the specific surgery to be performed.

The Joint Commission, the Netherlands Study, and Dr. Gawande are just the latest health providers to advocate the benefits of surgical checklists. Yet, only 25% of U.S. hospitals use a surgical checklist that has been proven to work according to Dr. Gawande. Based on the growing body of research, it is difficult to imagine why more hospitals do not require surgical checklists. In addition to saving lives, these checklists save costs associated with medical malpractice claims.

Posted by: Chicago Medical Malpractice Lawyer Jason M. Kroot

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