What is the Checklist?

If you’ve had surgery in the last decade you may recall being asked several times on the day of surgery questions like what is your name, what are you here for today, and do you have any allergies.  

When I was asked these questions a few years ago before undergoing shoulder surgery, I wondered to myself “Shouldn’t you know this? You’re operating on me!” – but now I understand; they do know, they are just following the Checklist.

The World Health Organization (WHO) Safe Surgery Saves Lives Surgical Safety Checklist (aka. the Checklist) is a simple tool that helps the surgical team to improve safety in surgery and has been proven to decrease operating room mortality by nearly 50%, as well as significantly decrease surgical complications and infections.

It doesn’t require fancy equipment or expensive drugs; meaning it can have as large of an impact in Dallas or Minneapolis as it does in Beijing or Nairobi or Toamasina.

The only piece of the Checklist that actually costs anything is the use of a pulse oximeter; so for this we have teamed up with Lifebox, an organization dedicated to ensuring every operating room in the world has this vital tool, to offer pulse oximeters where needed.

You might be thinking, “Well that sounds great and simple, just teach people how to use it!” – if only it was that easy.

The Mercy Ships Medical Capacity Building program has been working for years to try and figure out what it takes to successfully implement the Checklist in the local hospitals where we are serving.

Behavior change is hard; just because we know we should floss our teeth every day doesn’t mean we actually do it. Just because we know we should use a checklist before surgery doesn’t mean we actually do it.

We first experimented with some teaching in Guinea; expanded it in Congo, and this last field service in Madagascar we worked alongside the OR teams in Toamasina and Mahajanga to develop a practical, modified Checklist, tailored to the needs and requirements of the hospital.

This year we’ve expanded – from two cities to twenty! By empowering and inviting the OR teams themselves to develop their own checklist, we hope they will continue to use it long after Mercy Ships departs!

Through this simple checklist, we could see transformation of surgical care in this country and beyond.  

Stay tuned for the Checklist Project part 2 – Madagascar!

– Krissy Close, Medical Capacity Building Manager AFM

In the meantime, here is an overview of the steps: