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What’s New in the Patient Safety World

August 2022

Postprocedure Closeout Checklist Reduces Adverse Events

 

 

Most of the literature on checklists focuses on their use prior to surgery or other procedures. But how about using checklists after a procedure? A recent study (Siewert 2022) looked at the impact of a post-procedure “close-out” checklist during image-guided procedures. The authors found that the post-procedure close-out checklist improved patient outcomes by decreasing the number of adverse events that occur from inadequate safety processes at the conclusion of an image-guided procedure by 43%, the need for repeat procedures by 80%, and the severity of impact of an error.

 

Overall compliance with the postprocedure closeout checklist was in the high 90% range but compliance was lower in the group of patients with procedural errors reported (60%). In reviewing those incidents where the checklist was not used, the authors felt that most adverse events would have been prevented by use of the checklist.

 

Preventable errors were mostly related to obtaining and handling of specimens and retained foreign objects such as guidewires.

 

They did note some new error types after implementation of the checklist and plan to revise the checklist further. They anticipate that, with further modification of the checklist, 70% of incidents would have been preventable.

 

 

Some of our prior columns on checklists:

·       May 2019 “WHO Surgical Safety Checklist Cut Mortality 37% in Scotland”

·       July 16, 2019 “Avoiding PICC’s in CKD”

·       June 2020 “Are Two Checklists Better Than One?”

·       March 2021 “Medical Crisis Checklists in the ED”

·       June 21, 2022 “Preventing Post-op Pneumonia”

 

 

References:

 

 

Siewert B, Brook OR, Swedeen S, et al. Impact of a post-procedure close-out checklist on the incidence of preventable adverse events during interventional radiology procedures: an initiative to improve outcomes. Journal of Vascular and Interventional Radiology 2022; Published July 04, 2022

https://www.jvir.org/article/S1051-0443(22)01052-1/pdf

 

 

 

 

 

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