How key is following checklists to preventing surgical errors?

Doctors and other surgical support staff are trained to conduct "time outs" before making their first incision.

It's during this time that they're supposed to check to make sure that they're operating on the correct patient and the right body part. This is also supposed to be a time when all members of the medical team get on the same page in terms of their roles during the procedure. It's also during this time that all medical supplies and tools are supposed to be counted.

While doctors and nurses are supposed to take a few moments and do this to minimize the risk of surgical errors, it doesn't happen as often as it should.

When we hear of horror stories in the media, they often occurred because proper protocol wasn't followed before the operation took place. In other cases, appropriate post-operative procedures weren't followed. This includes counting all surgical supplies and tools before closing a patient up.

A few years ago, one surgeon and researcher set out to find out just how critical following a pre-surgical checklist is to reducing human errors that are most common during surgeries.

He had medical teams in eight different locales follow the same pre-procedure protocol. In doing so, patient mortality rates declined almost one-half from 1.5 percent to 0.8 percent. Surgical complications also decreased from 11 to just 7 percent.

A few years later, the researcher took 160,000 pregnant women in rural India and closely followed them as they gave birth to their babies. He also implemented a set protocol for doctors to follow in hopes of curbing infant or maternal mortality rates.

In the end, there were apparently no real improvement in rates on this front. The researcher conjectured that human behavior had a lot to do with the rates staying the same.

He notes that there were two groups, a coached and uncoached one. Medical staff that was not closely monitored failed to follow protocol in the overwhelming majority of cases. This contrasts greatly with the 60 to 80 percent of medical attendants that followed protocol during his original study. This sheds light on why little success was made in India whereas there was significant progress made at the eight sites.

If your health declined because proper protocol was not followed while an operation was being performed on you, then a Tucson attorney can advise you of your rights in your case.

Source: The New York Times Magazine, "Surgical checklists save lives — but cnce in a while, they don’t. Why?," Siddhartha Mukherjee, May 09, 2018

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