More evidence that hospital checklists may save lives

Earlier this year, a study published in the New England Journal of Medicine, that included more than 7,000 patients from eight hospitals around the world, found that implementing the use of surgical checklists reduced patient mortality rates by half, and patient injuries by nearly a third. Now, a new study published online in the British Medical Journal (BMJ) adds to the evidence suggesting the protective benefit of simple checklists.

To reduce mortality rates among patients at three hospitals administered by the North West London Hospitals NHS Trust, a team of clinicians, including the director of nursing, director of medical education and others, instituted eight different “care bundles” (or checklists) for the 13 diagnostic categories—including stroke and heart failure—that had the highest mortality rates in 2006–2007. After the checklist system was in place for one year, the medical team again looked at mortality rates using a hospital standardized mortality ratio (HSMR), a measurement which focuses on the major medical issues that cause 80% of all deaths throughout the U.K. They found that one year after implementation, in 2007–2008, the hospitals’ overall mortality ratio had dropped from 89.6 to 71.1. That measurement represents 174 fewer deaths in the 13 targeted diagnostic areas and 255 fewer deaths overall, the study authors say. In total, use of the checklists was associated with an overall drop in patient deaths of 14.5%.