In a Dec. 6 webinar hosted by Becker's Healthcare, Linda Lansing, senior vice president of clinical services, and Kelly Bemis, director of clinical services at Surgical Care Affiliates, discussed implementing a safe surgery checklist at a surgery center.
History & justification for checklists
Ms. Lansing began the webinar with an overview of the history of the surgical checklist. "If you look at the literature, you'll see that the development of checklists from a professional point of view ties back to the aviation industry — and, most significantly, to the aviation industry during the 1930s and 40s," she said. During that time, airplanes were gaining more sophisticated technology in the cockpit, causing problems for pilots who had previously operated more simple machines. Though the technology was intended to improve safety, it was widely considered "too complicated" for a pilot to manage. The number of crashes during this time period attested to the high error rate.
In examining the behavior of pilots in these new planes, experts found that the pilots with the most flying experience were not always the ones with the best results. "We usually think that time and grade in a profession will go ahead and give us competence, and competence will drive … safety and good quality results," Ms. Lansing said. But the human brain is flawed, and even the best training does not prevent a pilot from forgetting a crucial task for take-off.
"They really began to consider: How do you deal with extreme complexity?" Ms. Lansing said. "How do you ensure you complete every step in the process, particularly when that process is done very frequently?" Interestingly, the more frequent and routine a process was, the more likely errors were to occur. As it turns out, when you've performed the same task a hundred times, you fall into a certain sense of complacency about double-checking your work.
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