Checklists and cognitive aids: underutilized and under-researched tools to promote patient safety and optimize clinician performance

Abstract

Purpose of reviewChecklists and other cognitive aids serve multiple purposes in the peri-operative setting and have become nearly ubiquitous in healthcare. This review lays out the evidence for their use, shortcomings and pitfalls to be aware of, and how technology and innovation may improve checklist and cognitive aid relevance and usability.Recent findingsIt has been difficult to show a direct link between the use of checklists alone and patient outcomes, but simulation studies have repeatedly demonstrated an association between checklist or cognitive aid use and improved performance. When implemented as part of a bundle of interventions, checklists likely have a positive impact, but the benefit of checklists and other cognitive aids may be both context- and user dependent. Advances in technology and automation demonstrate promise, but usability, design, and implementation research in this area are necessary to maximize effectiveness.SummaryCognitive aids like checklists are powerful tools in the perioperative and critical care setting. Further research and innovation may elevate what is possible by improving the usability and relevance of these tools, possibly translating into improved patient outcomes.

Creating Explainable Dynamic Checklists via Machine Learning to Ensure Decent Working Environment for All: A Field Study with Labour Inspections

“…This indicates that the cross-validations are unable to accurately estimate the field performance of dynamic checklists. The discrepancies might be attributed to confounding factors related to the use of checklists in the real world that are not accounted for in the cross-validation, such as how users interact with their checklists [16]. Cross-validation may still not be completely unreliable, as Figure 7 shows that dynamic checklists consistently outperform traditional checklists in both the cross-validations and field study.…”

Initiatives to detect and prevent death from perioperative deterioration

“…To prevent occurrence of complications or treat complications adequately, checklists and cognitive aids can help medical staff to remember all essential steps in an acute treatment plan or during a complex procedure. Currently, with an ever-increasing focus on patient safety and high quality of care [10], the use of checklists and cognitive aids, both inside and outside the operation theatre, are indispensable and gain increasing popularity [11][12][13].…”