Rob Dixon, the Business Development Director from Pilotwise, has shared some thoughts on the use of checklists in healthcare. His thoughts have been prompted by an academic paper on the effectiveness of checklists to aid flying from the 5th International Conference on Applied Human Factors and Ergonomics, 19-23 July 2014.
Rob notes that “whilst this research example was all about flying, there is direct read-across to other areas where highly-qualified, professional humans operate in an environment of possible 3rd party death (and resultant public condemnation of their actions)”. We hope Rob’s blog article below is thought provoking, and we welcome your comments…
The paper from the 5th International Conference on Applied Human Factors and Ergonomics, 19-23 July 2014 considered that checklists (digital and paper-based) and standard procedures have been established to help pilots act in abnormal, often critical situations; these tools have to be as accurate and comprehensive as possible, but also short and easy to handle. It also considered that the procedures and checklists that are meant to support pilots in extreme situations might be inappropriate sometimes. The supporting research placed pilots in an abnormal flying situation (loss of a hydraulic system for those that understand aeroplanes) and added the time pressure of reduced fuel. The authors believed that procedures and checklists, for their abnormal situation, emerged as inappropriate. The results were usually the required task not being accomplished in time, or not even started. Errors became apparent due to attention errors, misinterpretation or print font size, and required further research into crews’ mental models, performance and communication.
Aviation and medicine have many areas of similarity in human performance terms, one being that human must store large amounts of data for timely recall. Often the recall for decision-making is required in time critical situations, where a delay could be catastrophic. In such scenarios, checklists can aid decision-making or guard against the omission of steps in a procedure. Highly-trained humans (medical staff or aircrew) are still vulnerable to errors and/or mistakes, particularly if there is limited time in which to think and operate.
There are many areas of the medical world where standardised checklists would reduce the incident of mishap; however, checklists must be generated effectively and used correctly, so as not to increase the time in dealing with a situation, make it more confusing, stifle experience, or make staff solely reliant on their use.
Are checklists required in the medical world? If so, in which areas and who should be involved in their generation?