6 Things Every Physician Needs to Know About Checklists from LifeWings

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With a small commitment of time, effort, and leadership, surgeons can get documented improvement in patient safety and quality care, a better place to practice medicine, reduced exposure to malpractice risk, increased efficiency, and financial return on their investment with LifeWings. http://www.saferpatients.com

LifeWings is a patient safety consulting firm that is strongly committed to making a difference in healthcare. The company's training is based on aviation principles and notes the similarity between pilots and their flight crews and physicians and their medical teams. There is a growing body of evidence that CRM-based patient safety programs have the same error-reducing effect in health care settings as in other industries.

Steve Harden, CEO of LifeWings, offers these six things every physician needs to know about CRM-based programs in the OR:

1) Teamwork training programs and checklists are evidenced-based and improve patient care. Multiple peer-reviewed studies have documented that teamwork training and checklists reduce preventable errors and medical malpractice suits, and increase the safety and quality of patient care.

In the OR, surgical teams who have had teamwork training demonstrate significant increases in the quality of pre-surgical procedure briefings and the use of effective teamwork behaviors to overcome communication errors during cases. Surgical teams using a scripted patient handoff checklist reduced technical and communication errors and provided improved patient information transfer. Those OR teams using a pre-procedure checklist reduced the rate of deaths and complications by more than a third, reduced unplanned returns to the OR, and reduced surgical infections.

2) Not only are they the right thing for the patients, teamwork training programs and checklists create a better place to practice medicine.

Improved teamwork and communication between clinicians has been linked to improved job satisfaction, lower job stress, and reduced turnover. In the OR, preoperative briefings have been shown to increase team satisfaction and improve the OR safety climate. Better teamwork performance has also been linked to improved patient satisfaction.

3) Off-the-shelf Checklists rarely work well. They must be customized to local practices. Checklists must be created by the clinicians who will actually use them, and not by administrators or the staff at another hospital. Effective checklists are modified to fit the culture, work flow, and practice patterns of the institution where they will be used.

The most successful checklists are site and surgery-specific and developed in a collaborative manner responding to the needs and views of all members of the care team.

4) Teamwork training and checklist usage have a financial ROI. The financial rewards of effectively using a teamwork training and checklist program can be substantial. Captive insurers have extended a 10% reduction in malpractice premiums for physicians who participated in teamwork training and completed online courses. It is not uncommon for hospital insurers to extend six-figure premium rebates (to as much as $270,000) to the institution in response to the improved claims experience. Because fewer errors are being made, institutions have experienced as much as a 50% decrease in open claims files for potentially compensable events and a 33% decrease in claims dollars per surgical discharge.

5) To get the benefits of patient safety, efficiency, and financial return, physicians must lead the use of checklists. Steve Harden also notes, “In aviation the Captain of the crew leads the use of any checklist. Likewise, the most successful checklist implementations I have seen in health care are those where physicians lead the checklist process. They "call" for the checklist at the appropriate time and give checklist usage their undivided attention. Surgeon will always lead the start of any checklist. It should always be clear to the entire surgical team that the surgeon is in charge of the checklist process. An effective checklist is actually a standardized communication tool. It is not a "tick sheet" designed just to get a check in a box.”

6) Effectively using checklists require only a small investment of time. Once expertise is gained, the length of time required to accomplish an effective briefing and checklist typically takes 1 minute or less, and there will be zero delays in start times.

In summary, for a small outlay in time, effort, and leadership, surgeons get a documented improvement in patient safety and quality care, a better place to practice medicine, reduced exposure to malpractice risk, increased efficiency, and a financial return on their investment.

LifeWings Partners creates documented, sustainable improvements in cost reduction, efficiency, reliability, safety, and quality by combining the best of Lean and TeamSTEPPS. LifeWings has improved the financial bottom line and patient safety record of over 140 hospitals worldwide. The LifeWings coaching cadre of pilots, astronauts, physicians, nurses and Toyota-trained Lean experts train more than 13,000 administrators, physicians and staff per year. Measurable results are guaranteed in all LifeWings’ initiatives. Documented return on investment typically exceeds 300%. To find out more, please visit http://www.saferpatients.com or https://www.facebook.com/LifeWingsSaferPatients or follow us on Twitter @LifeWingsLLC.

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Stephen Harden

Angela Myers
LifeWings Partners, LLC
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