While it may be true that to err is human, making mistakes is also a luxury that is not afforded to all humans alike. For people working in high-risk professions, such as in the civil aviation or medical industries, a simple mistake can have fatal consequences and must be avoided where possible.
Numerous studies have been carried out examining the tragic impact human error can have on clinical practice. A landmark study released in 2009 was one of the first to draw attention to a simple yet effective solution to the problem – the safety checklist.
In 2011, the Cardiovascular and Interventional Radiological Society of Europe (CIRSE) created one of the first safety checklists for interventional radiology (IR). one year after it was published, the checklist is proving a valuable tool for improving IR patient safety in Europe.
Improving safety, one tick at a time
Many groups have a vested interest in patient safety and it is not hard to understand why – improving patient safety can save money, reputations and most importantly, it can save lives. However, it may not be clear how a simple checklist can help improve patient safety.
The minimally invasive nature of IR means that it leads to fewer complications than surgery. However, complications do occur. The unique combination of diagnostic and cutting-edge interventional techniques used in IR procedures gives rise to complex procedural steps – steps that must be strictly adhered to.
According to CIRSE President and main author of IR Safety Checklist, Professor Michael J. Lee “The advantage of a safety checklist for IR is that its ensures that human error in terms of forgetting key steps in patient preparation, intra-procedural care, and postoperative care are not forgotten” .
Another benefit the checklist brings was highlighted by Professor Patrick Haage of Helios Klinikum in Wuppertal, Germany, who implemented the checklist in his hospital in 2011. “The checklist has helped us to attain and maintain consistency and reliability for the benefit of patient safety.”
In Professor Lee’s institution, Beaumont Hospital in Dublin, Ireland, the checklist had also “…helped build rapport within the IR team and most importantly, it has meant that all patients receive appropriate peri-procedural care and medications that help prevent complications.”
How it works
The checklist was created by an expert group of IRs and tested in four European hospitals. First published in 2011, the single-page document was based on the WHo Surgical Checklist and the Dutch RAD PASS Safety Checklist for IR.
Comprising three sections – “Procedure Planning”, “Sign-in” and “Sign-out” – the checklist can easily be modified to suit the requirements of individual hospitals. Professor Lee also explained that “The checklist was designed to be general so it can be applied to a wide variety of interventional procedures. ”
A Forecast For Success
Although checklists are commonplace in various other high-risk professions, their use in medicine is a more recent development. The renowned Surgical Safety Checklist, sponsored by the World Health organisation (WHO), was the first medical safety checklist to gain widespread acclaim from various institutions around the world.
The WHO Surgical Safety Checklist was used as a model for CIRSE’s IR Safety Checklist and is therefore seen as an indicator of the possible benefits that implementing an IR safety checklist can bring. The WHO Surgical Safety Checklist first came into the limelight when the results of a year-long pilot study on it were published in the New England Journal of Medicine in 2009. The study highlighted how the checklist had led to reductions in complication rates of over 33% and significant decreases in mortality rates.
Subsequent studies confirmed the findings of the initial pilot study, estimating that as much as half a million deaths per year can be prevented simply by implementing the WHo Surgical Safety Checklist . The WHo Surgical Safety Checklist is now being used in over 1,800 hospitals around the world.
A Promising Future
Despite its recent introduction, CIRSE’s IR Safety Checklist has already seen its first successes. Currently in place in various hospitals throughout Europe, it has led to significant improvements in the safety dynamics of these institutions. The IR Safety Checklist was also well received by the European Commission’s Health and Consumers Directorate-General and CIRSE representatives have been invited to Brussels for talks on patient safety in IR.
CIRSE hopes that the widespread adoption of the checklist will lead to improvements in patient safety within Europe and also well beyond its borders. The society has made the checklist available, freeof- charge, on its website. The checklist can be modified to suit individual institutions or IR practices.