According to Gawande, modern health systems are becoming more and more complex as technology and specializations develop. People are seeking out the best treatments and specialists, but that does not always result in the best overall healthcare (TED, 2012). High-reliability organizations (HROs) are becoming a central concept in healthcare as ones that promote a culture of safety and consistency. They are the ones that would thrive on the systems approach Gwanande is describing.
The use of the checklist tools is being actively implemented in HROs as a method to reduce risk and incidence of adverse events in high-risk medical environments. These checklists are used commonly for medication safety by evaluating medication management and communication tools. Medication administration which is inherently complex on its own significantly benefits from a checklist for routine tasks that are completed by memory but allows a fallback in case anything is missed.
The intricate process requires a balance of clinical judgment, critical thought, and professional vigilance (Yip & Farmer, 2015). Since safe and efficient medication administration is vital to the highly reliable practice, the checklist ensures that is the case in HROs.
At the place of employment in primary family care checklists may be helpful to an extent. Usually, there are few high-risk situations where it would be required, but a checklist may be helpful to maintain the structure. It is always possible to implement practice improvement checklists for long procedures such as annual checkups to ensure that nothing is missed. This would potentially help improve the quality of the procedures and help to better evaluate the health status of patients.
A checklist commonly utilized in healthcare settings is a patient handoff chart. These are structured measures meant to mitigated poor or hurried communication that commonly occurs when patients are admitted into a hospital or switched among departments and specialists. Evidence-based care promotes patient handoff checklists as a standardized communication method. It has greatly improved outcomes, decreased adverse events, and lowered handoff time as patients are transferred between care teams which is a complex process (Coon et al., 2015). Overall, checklists prove to be a beneficial and systematic tool based on evidence that can improve healthcare outcomes significantly with simple and minor changes to practice.
Coon, E. A., Kramer, N. M., Fabris, R. R., Burkholder, D. B., Klaas, J. P., Graff-Radford, J., … Jones, L. K. (2014). Structured handoff checklists improve clinical measures in patients discharged from the neurointensive care unit. Neurology: Clinical Practice, 5(1), 42-49. Web.
TED. (2012). How do we heal medicine? | Atul Gawande. Web.
Yip, L., & Farmer, B. (2015). High reliability organizations—Medication safety. Journal of Medical Toxicology, 11(2), 257-261. Web.