• Stephen Harden

How to Make Better Healthcare Checklists





On the bottom of the World Health Organization Safe Surgery Checklist are these two sentences: "This checklist is not intended to be comprehensive. Modifications to fit local practice are encouraged."

This item on the checklist is the most important because ignorance of this advice from the WHO is the source of almost 90% of checklist implementation failures.


Successful checklists are created by the physicians, nurses, and staff that actually use them. Ineffective checklists are imposed from above by administrators without regard to local practice or input from end-users.


For example, at Piedmont Heart, an interdisciplinary team created its own Time Out checklist. Because of its proven record in reducing surgical morbidity and mortality, relative ease of use, and focus on improving interdisciplinary team communication practices, the WHO Surgical Safety Checklist was used as a major point of reference in the design of their checklist.


Under LifeWings guidance, an interdisciplinary task force modified the checklist and inserted cardiovascular language and concerns to make the WHO Surgical Safety Checklist and its communication practices more applicable to CV procedures in their institution.


With the help of this checklist, Piedmont Heart totally eliminated serious safety events.


Here's a graphic of their results.



Successful checklists , that eliminate harm, are created by the physicians, nurses, and staff that actually use them. Ineffective checklists are imposed from above by administrators without regard to local practice or input from end-users.

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