Another big win for checklists

Here is something you should ask your doctor next time you see them. Especially if they are about to cut you open.

Do you use a checklist?

In a study involving nearly 8,000 people in 8 hospitals around the world, checklists were found to cut deaths nearly in half. Those results were published in today's New England Journal of Medicine.

I have been writing about checklists and their chief advocate, MacArthur "genius" Peter Pronovost, for a couple of years now.

I doubt the profession is done fighting Pronovost. But the science seems clear. And it may be time to extend the use of checklists to other areas beyond surgery.

Specifically I'm thinking here of the work done by Brian Klepper and David Kibbe. They advocate bringing results from decision support into standard clinical practice.

The best way to do this is with a checklist. You can run a checklist on each standard exam, and build a decision tree, in an online form, to guide diagnosis and treatment.

The electronic checklists could be updated regularly, and while deviations would be permissable, they would have to be explained, and doctors held accountable.

That last may be a ways off.

The problem is that while doctors like the idea of their underlings using checklists (the above is one for immunizations, from the CDC) they seem to think they should be immune from this discipline.

But anyone can benefit from the discipline of a checklist and the more complex the task the more they benefit.

You can even have a little fun with it. Make plane noises when you start cutting. Show the checklist to patients before you operate. Make medicine more transparent.