Lessons Learned from the Aviation Industry: Surgical Checklists

Abstract

Checklists are the foundation for safety and quality control in the aviation industry. The concept developed from a disaster in 1935 and to date checklists are a dynamic tool within aviation and aircraft maintenance, regularly audited and adjusted to prevent avoidable error or accidents. Other high-risk industries such as nuclear and oil drilling industries have adapted the checklist principle as a means to improve safety. The recent introduction of the WHO checklist for safe surgery has demonstrated a reduction in perioperative mortality and morbidity and has led to an implementation on a grand scale around the world. The checklist principle though is not novel to health care, many hospitals have used preoperative checklists for years. Critics have therefore dismissed the WHO checklist as “the emperor’s new clothes.” However, the initial results of the WHO checklist should encourage surgeons to implement checklists as a tool for quality control toward safety-oriented health care.