From the Guidelines
Review of History and Evolution of Checklists
The history and evolution of checklists have significantly improved safety and standardized procedures across multiple disciplines, with the most recent and highest quality study in 2023 highlighting their widespread use and positive impact in intensive care units 1. The concept of checklists originated in aviation during the 1930s, following the crash of the Boeing Model 299, which led to the development of pilot checklists to manage complex aircraft operations. The military adopted checklists during World War II to ensure consistent performance in high-stress situations. By the 1950s, industries with complex operations began implementing checklists to reduce human error and standardize procedures. The healthcare sector first experimented with checklists in the 1970s for anesthesia protocols, though widespread adoption was limited. In the 1980s, nuclear power and other high-reliability organizations incorporated checklists into their safety protocols following major incidents like Three Mile Island. The 1990s saw increased interest in checklists for medical procedures, particularly in intensive care settings for preventing central line infections. A significant advancement occurred in 2001 when Peter Pronovost at Johns Hopkins developed a five-point checklist that dramatically reduced catheter-related infections. The World Health Organization formalized the use of surgical safety checklists in 2008 with their "Safe Surgery Saves Lives" campaign. A landmark study published in the New England Journal of Medicine in 2009 demonstrated that surgical checklists reduced mortality and complications by over 30% 1. By 2010, electronic checklists began replacing paper versions in many industries, allowing for better data collection and analysis. The aviation-inspired Surgical Safety Checklist became mandatory in many countries by 2012, demonstrating cross-disciplinary knowledge transfer. In 2013, Atul Gawande's influential book "The Checklist Manifesto" popularized checklists beyond professional circles. Research in 2015 expanded checklist applications to emergency medicine and trauma care. By 2017, checklists had evolved to include decision-support elements rather than simple verification tools. Studies in 2018 demonstrated the effectiveness of checklists in reducing diagnostic errors in primary care settings. In 2019, researchers began focusing on checklist design psychology and human factors engineering. The COVID-19 pandemic in 2020 prompted rapid development of clinical checklists for managing novel treatment protocols. By 2021, artificial intelligence began being integrated with checklists to create adaptive protocols that respond to changing conditions. Recent research in 2022 has focused on customizing checklists for different cultural contexts while maintaining core safety elements. The latest evolution in 2023 involves the development of patient-centered checklists that engage patients as active participants in their care processes, as highlighted in the study published in Critical Care 1. Some key steps to develop effective checklists include reviewing existing literature, understanding the needs and workplace of the users, including a multidisciplinary group in the design, and using an iterative approach for rigorous pilot testing and validation of the tool 1. The process of creating checklists should incorporate diverse input, such as empiric evidence, tacit experience, local input, regulatory input, and community input, to ensure they are effective and efficient at improving patient care. Checklists with elements that pose risks or those that exclude important elements may be neither effective nor efficient at improving patient care, emphasizing the need for careful development and validation. Overall, the history and evolution of checklists demonstrate their potential to improve safety, reduce errors, and enhance patient care across various disciplines, with ongoing research and development aimed at further optimizing their design and implementation.
From the Research
History and Evolution of Checklists
- The concept of checklists has been around for nearly a century, with its origins in high-reliability organizations (HROs) 2.
- Checklists were first introduced in healthcare in the early 2000s, with a focus on improving patient safety and reducing medical errors 2.
- The use of checklists in healthcare has evolved over time, with a shift from paper-based to electronic checklists 3.
- Electronic checklists have been shown to improve the efficiency and effectiveness of healthcare processes, but their adoption has been slow due to various challenges 3.
- Checklists have been used in various healthcare settings, including surgery, intensive care, and emergency medicine, to improve patient outcomes and reduce complications [(2,4,5)].
Development and Implementation of Checklists
- The development and implementation of checklists require a thorough understanding of the underlying processes and the needs of the end-users 2.
- Checklists should be short, self-developed, and operationally-suited to ensure acceptance and compliance 2.
- Simulation is a valuable method for training, revision, and validation of checklists 2.
- The use of checklists in healthcare has been influenced by the aviation industry, where checklists have been used to improve safety and reduce errors 3.
Evaluation of Checklists
- The evaluation of checklists is crucial to ensure their effectiveness and identify areas for improvement [(3,6)].
- Checklists should be evaluated based on their content, structure, and usability 6.
- The use of milestone checklists in pediatric care has been evaluated, with findings suggesting that there is limited overlap in content and inconsistent age ranges 6.
- Further research is needed to validate the use of checklists in healthcare and to develop standardized checklists that can be used across different settings [(2,3,6)].