Procedural Checklist/Situational Awareness

Abstract

The modern aviation checklist was developed in the aftermath of the Boeing Model 299 crash on October 30, 1935 (Marquet 2012). To avoid another accident, the Army Air Corps personnel developed a series of checklists the crew would follow for takeoff, flight, before landing, and after landing. Following the success of implementing a “safety culture,” aviation checklists have been employed in medicine to successfully reduce surgical morbidity and mortality as well as mitigating other complications such as central line sepsis. The impact of the surgical checklist can be further improved by applying closed loop communication and enhancing situational awareness in the operating room. Barriers to successful implementation of a checklist can be overcome by developing a strong commitment to education as well as a cultural shift to focus on the importance of empathy, empowerment, employee engagement, and trust within the organization while flattening the authority gradient. Each specialty area should identify a Paladin to facilitate and strengthen the organization’s commitment to utilizing surgical safety checklists.