"The Surgical Check List"... Its like a fighter pilots checklist... But not really...

Medicine has been stealing safety ideas from the aviation industry for quite some time.   If you don't believe me, talk to any older anesthesiologist and they'll give you the scoop.  They will tell you all about when they had to actually pass gas by hand (got that image in your mind?...Yes!) and how modern anesthesia consistently sets the bar for safety standards in medical practice.  They always brag about this, usually between their crossword puzzle and post intubation nap(I kidd I kidd!)!

Even though it may have taken surgeons a while to figure out how to improve their outcomes across the board, today surgeons around the world can look at their anesthesiologist with delight and happily start a discussion about that new study from the New England Journal of Medicine...

Pass the Sudoku...

The New England Journal of Medicine NEJM (also known as the "New England Journal of Rejection" if you have ever tried submitting a paper there) just published an article entitled, "A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population." In short, the paper states that, "The rate of death was 1.5% before the checklist was introduced and declined to 0.8% afterward (P=0.003). Inpatient complications occurred in 11.0% of patients at baseline and in 7.0% after introduction of the checklist (P<0.001)."> concomitant reductions in the rates of death and complications among patients at least 16 years of age who were undergoing noncardiac surgery in a diverse group of hospitals."

The idea of having a pre operative surgical checklist seems like a pretty simple tool to use to improve the outcomes of any operation.  Its also pretty cheap! More money for the medical malpractice lawyers.. YES! The results of the study in my opinion are remarkable... Now my question is...

If the surgical check list is based on the same format as check lists used by aviators, is it appropriate to drop you voice down real low, give yerself a sweet southern drawl and pretend like your Maverick from Top Gun while reading the surgical check list?  

Lets hope so!

This video is from http://www.scoap.org/checklist/SCOAP stands for Surgical Care and Outcomes Assessment Program, it is based in Washington State

I found this video of Dr. Atwal Gawande author of, "Complications: A Surgeon's Notes on an Imperfect Science an Better" and "A Surgeon's Notes on Performance" and many other books just while I was cruising around YouTube.  Here they are performing a "Surgical Checklist."



Below is what happens when inexperienced co pilots get through the check list but dont have adequite training...The take home lesson for surgeons from the video below is... DONT PASS OUT! But its only because your anesthesiologist is waiting to laugh at you!