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Checklists in hospitals may not prevent surgical errors

Surgical errors are tragic and yet unfortunately common. The other week we discussed some of the simple procedural changes that are not taking place in American hospitals despite the high rate of serious medical mistakes. This week the Atlantic Magazine published an article on the use of checklists to prevent some of these surgical errors and a lively debate about how worthwhile such checklists might actually be. Maryland readers may find the following blog on surgical errors and the use of checklists interesting.

According to the article discussed above a study of malpractice judgments and out-of court settlements by

Johns Hopkins researchers in Baltimore, Maryland, so called "never events" such as wrong patient or wrong site operations or leaving surgical instruments inside patients actually occur more than 4,000 times every year in U.S. hospitals. A far more common occurrence than the never event title might lead a patient that is about to undergo surgery to believe at first blush.

For many hospitals, the solution to such these types of surgical errors was to implement checklists. The idea was that such lists would prevent this type of error and ideally prevent the costs associated with their occurrence. The major push for checklists allegedly followed the publication of a book by a Harvard professor called "The Checklist Manifesto." The book relied heavily on research in the New England Journal of Medicine that found such checklists reduced the rate of death by almost 50 percent.

Interestingly the Atlantic article discusses follow up studies of hospitals that have since introduced the use of checklists and found that the lists did not seem to produce the expected results. However, supporters of the use of checklists suggest the follow up studies results did not properly address the benefit of checklists because the monitored hospitals failed to use them correctly. In the end, when a patient is harmed due to a surgical error, list or no list, they may want to consult a medical malpractice attorney. An attorney can help explain the patient's legal options, including the possibility of seeking compensation through a lawsuit. Such compensation may include recovery for medical expenses, both past and ongoing.

Source: The Atlantic, "Save a Brain, Make a Checklist," James Hamblin, March 17, 2014

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