How to Save Lives: The Power of Checklists

Photo by Glenn Carstens-Peters on Unsplash

Checklists are used all over. « To-do list », « Task list » are different ways to speak about checklists. It’s a list of items or tasks to check once completed. Checklists have one important aim — to help you remember.

Your Memory Will Play You

As good as your memory could be, it happened to everyone to forget to pick your child up at school or to attend your date with Beyoncé. As important as it could be, one brain may bury these events so deep in the strata that you won’t remember them. I know, these are extreme cases, but what if you had them written down? Perhaps, your kid’s teacher would have never hated you because of the extra time you made her do or maybe, and more importantly, Beyoncé would not have reconnected with her ex boyfriend leaving you with regrets and no topic to brag about at your weekly friend’s dinner. Frustrating, isn’t it? Jokes aside, checklists can change your life, literally.

Checklists Save Lives

I won’t speak about the checklist pinned to the fridge. Agreed, it can ruin a relationship when failed to complete simple tasks written with love on the green sticky note. But it is not life and death issue. The life-saving checklist of interest occurs in a healthcare environment. To be precise it happens everyday in the OR at the hospital.

Checklist is a powerful tool.

Surgeons, anesthesiologists and nurses are doing their best to preserve lives. Sterilizing surgical tools, using disposable accessories, and taking serious care of the patient, health professionals involved in surgical procedures are working together with one and unique goal in mind — improving patient’s health. As exceptional the staff can be, the likelihood to make mistakes and to impair the outcome of the surgical procedure is nevertheless present.

After all, we are humans.

Life issues can weigh on of us and interfere with our actions without exceptions — messing up with our brain and masking from our awareness the next step which, for the love of god, we’ve previously performed a million times. This specific step can be essential for the entire operation.

According to Murphy’s law, the missing step is always the crucial one.

By the time one realized the mistake, it is already too late. What’s done is done. One has to deal with the consequences — often dramatic. Such oversights leads every year to people dying on the operating table during surgery or even later on, a victim of complications.

WHO Surgical Safety Checklist

In 2008, the World Health Organization (WHO) launched the WHO Surgical Safety Checklist. This initiative proposed to reduce the mortality related to surgery with implementation of a list of tasks to do before, during and after surgical procedures. The principle here is simple. The list currently contains exactly 19 items. The staff member performing one of the specific task becomes accountable for it.

This WHO initiative revolutionized surgical interventions in the OR. As covered in the British Journal of Surgery, the implementation of the surgical safety checklist led to reduce the relative perioperative mortality in Scotland by more than a third. It is more than 20,500 saved lives. On a larger scale, 313 million surgical operations are performed across the globe every year. Indeed, we can’t extrapolate directly the fantastic rate of improvement obtained in Scotland’s hospital as it depends on various factors such as socio-economical status as well, but it is safe to say that many lives saved across the world.

Key Points

• 313 million operations per year in the world [1,2].

• WHO Surgical Safety Checklist implemented in 2008.

• Study published in British Journal of Surgery reported 36.6% relative reduction in perioperative mortality in Scotland after using the WHO surgical safety checklist. It is equivalent to more than 20,500 lives saved.

Checklist to Prevent Virus Spread

To continue in the theme of saving lives, writing down a list of tasks to help preventing virus contamination is probably the best thing to do in a timely context.

In a general manner, a virus spread and contamination checklist must include basic hygiene rules like cleaning and disinfecting. An example of seven tasks representing good habits dedicated to prevent virus spread can be found in the article here.

I would recommend using subcategories in accordance to your lifestyle and environment. For instance, in a category called « House cleaning » or « Housekeeping », subcategories may include specific tasks such as door knobs, switches, etc… Additionally, in a separate category called « Hand Wash » for instance, subcategories may include soap, sanitizer and also specific anticipated hours to do it. This will definitely help to find a routine of good hygiene habits during the epidemic season we are experiencing with COVID-19 and indeed, the Flu virus.

Checklist is a powerful tool. Beside improving productivity, checklists are crucial to make sure successful procedures can be reproduced. If you follow the recipe step by step, the dish will always taste as good as you remember.

References

[1] Maera GM et al.Global Surgery 2030: evidence and solutions for achieving health, welfare, and economic development. Lancet. 2015;386(9993):569–624. doi: 10.1016/S0140–6736(18)33139.

[2] Global burden of postoperative death. Lancet. 2019;393(10170):401. doi: 10.1016/S0140–6736(18)33139.