Dentists: Heed the Incredible Power of the Checklist

Whether you're a dentist, surgeon, or airline pilot, checklists can dramatically improve performance. In fact, Russell Taichman, professor of dentistry at the University of Michigan, has co-authored a study with two pilots about how airline crew resource management (CRM) checklists can be applied to dental care.

This study of CRM and dentistry proposes breaking the dental visit into five distinct stages, each with its own explicit checklist.

It was some 30 years ago that airlines realized that CRM could reduce human error, the cause of most accidents. Within that industry, studies have consistently found significant – even dramatic – reductions in accidents when airline checklists are used.

Since then, other industries have taken notice. Once a revolutionary concept, the use of medical checklists has rapidly become the new standard.

Dr. Atul Gawande, an associate professor at the Harvard School of Public Health, pioneered the field of medical checklists. He was named a MacArthur fellow in 2006, and his surgical safety checklist has been credited with reducing hospital death rates by as much as 50%.

The results of using a pre-surgical checklist have spoken for themselves. There are fewer deaths and fewer complications (about one-third less, according to some research) – and hospitals are even saving money by not having to treat those complications.

While hospitals have been eager to adopt the checklist, doctors and staff have been somewhat more reluctant. In a real-world setting, many surgical teams do not actually consult an itemized checklist.

But it seems to me patients would love to know their surgeon or dentist was using a checklist before each and every procedure. You could even mention it in your dental marketing as a patient benefit!

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http://www.thevisibledentist.com/ The Visible Dentist

Although studies do suggest pilot errors have decreased, accidents have only slightly diminished since the 1980′s. The totals over time remain nearly the same. Many experts attribute mechanical malfunctions now as the leading cause in flight mishaps.

While I would certainly like to see checklists employed in dentistry, still, any checklist is only as effective as the person who chooses to follow it.

Below are a few articles which seem to refute the efficacy of checklists, or any other medical safeguards in hospitals, where most surgery is performed.

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Patient Safety Incidents at U.S. Hospitals Show No Decline
http://tinyurl.com/2eup6av

US Hospitals Cover-up Medical Errors with No Federal Oversight
http://tinyurl.com/2aaf89w

Hospitals Are a Major Health Hazard
http://tinyurl.com/29xxsrk

Medical Errors – Third Leading Cause of Death
http://tinyurl.com/4xm8oe

Hospital Mortality Rates Not Ready For Prime Time
http://tinyurl.com/2dyp2cv

Death Rates Not Best Judge of Hospital Quality
http://tinyurl.com/29yzusu

The number of people who die annually from infections acquired in a hospital is equal to that of all those who die from every form of accident — cars, planes, boats, falls, etc.

John Barremore
Houston, TX
http://www.jasperdentalassociates.com Susan Catton

We’ve been using “Daily Duties Checklists” for years. They help keep the staff focused on getting through the day and helps the team run more effeciently, less duplication of effort. Establishing a dental procedure checklist (from treatment room and instrument set-up to patient communication and dismissal) ensures uniformity in delivering patient care, no matter who is working togther.
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http://www.torontodentist-smileblog.com Toronto Dentist in Etobicoke

Love this post on checklists. I find this such a struggle with experienced team members who feel insulted by the idea of a checklist.

Joe
Michael

Joe, you need to sit your staff down and let them participate in formulating the check lists then let them know that they WILL be followed. I am a surgeon, there was considerable push back in the hospital we the Universal Time Out required by The Joint Commission was implemented. The nurses were basically told, do it this way or find another job. In our office (AAAHC acredited) we have been using check lists and the Universal Time Out for years. It is now just second nature for all team members.
D. Kellus Pruitt DDS

Personally, I think one can easily make dentistry much more complicated than it has to be with good ideas.

Checklists might be handy for a few compicated procedures, but I think it would be silly to check off that adhesive has been applied and cured.
http://www.drkarlsmith.com/ Gum Disease Treatment

Checking anything is a typical tasks but it can be resolve by step by step , checklist your work is just a walk step by step in your procedure . Mostly this kind thing generally watch in Doctor paper where they firstly talk to patient and note all its problem and then solve step by step …