WHO needs changingBMJ 2010; 340 doi: https://doi.org/10.1136/bmj.c909 (Published 23 February 2010) Cite this as: BMJ 2010;340:c909
Vats and colleagues fail to recognise the intrinsic faults of the current checklist.1 If adherence to the checklist is to be improved, it must be workable and acceptable to all staff. One limiting factor to adherence was that it caused embarrassment—this would not occur if it didn’t contain some inappropriate points. Rigidly enforcing an inappropriate checklist is counterproductive, and it is no surprise that once supervision decreases compliance falls. The current version does not ask questions early enough to enable corrective action to be taken. For example it is too late to wait until the patient is anaesthetised and draped before asking if the patient’s position is correct, or whether extra equipment or blood transfusion is needed.
It is not impractical to have a briefing before starting the list as Vats and colleagues claim: it takes place informally already. If this is strengthened as part of the checklist then theatres will run more smoothly, with everything in place in a timely fashion. Continued duplication of checks is unnecessary.
A theatre checklist enhances compliance with established safe practice. The checklist format shouldn’t be adopted and then adapted. It needs to be revised to an acceptable format and then used appropriately, nationwide, as soon as possible.
Cite this as: BMJ 2010;340:c909
Competing interests: None declared.