Surgical checklists 'cut' malpractice

2011-01-14 10:27

kalahari.com

New York - Surgical checklists not only save lives by preventing medical errors, they could also make a big dent in medical malpractice claims, according to a study in the Netherlands.

Using data from the country's largest medical liability insurer, a team led by Eefje de Vries of the Academic Medical Centre in Amsterdam found that nearly a third of the malpractice claims arose from mistakes that likely would have been caught by a checklist.

For the study, published in the Annals of Surgery, the team identified the main reasons for errors in 294 successful insurance claims related to surgeries from 2004 to 2005. They then compared those to the items on a comprehensive surgical checklist called Surpass, which is now used in several hospitals in the Netherlands.

The checklist includes things such as making sure the operating schedule is correct, checking that all equipment is available, and marking on which side of the patient the surgery is going to happen.

"While the checklist as a whole may seem a little intimidating, the separate parts for each stage of the surgical pathway take little time to complete," de Vries wrote.

Costs


They found that 29% of the reasons for lawsuits could be linked to a step on the checklist, such as marking the patient or communication between hospital staff.

And in four of the 10 deaths in the claims database, at least one of the contributing factors was addressed in the checklist.

While there is no guarantee the checklist would have avoided those deaths if it had been used at the time, the researchers say it would likely have prevented "a considerable amount of damage, both physical and financial".

The costs are significant.

Putting a price tag on the medical liability system is difficult, but one 2010 study estimated it costs the US more than $55bn annually, or 2.4% of the country's healthcare spending.

In addition, experts say tens of thousands of Americans die each year due to medical errors.

Complications


Earlier studies have shown that when healthcare providers follow a checklist, they reduce those deaths dramatically and could save money by preventing complications that require further treatment.

"This kind of evidence indicates that surgeons who do not use one of these checklists are endangering patients," said Atul Gawande at the Harvard School of Public Health, a surgeon who has written extensively on the topic.

Yet only about a fourth of US hospitals use one of the three checklists that have been proven to work, he added.

"The message for hospitals is you want to adopt one of these checklists," he said.
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