Radiologists Should Adopt Checklists

Patient checklists have gained popularity in operating rooms and inpatient centers in recent years. The World Health Organization advises their use in a several environments, even for well child checks. At their core such checklists take a complex process and make it fundamentally reliable in some core way, that either the user determines or that a consensus of users determine.

For a radiology practice, that might include content of reports in a consistent way, use of comparison studies, or reminders for regular checking of report status. They improve safety and are, for many, a no-brainer.

Although we all believe ourselves to be safe and effective at our jobs, there is no question that we lapse into a false sense of security at times. At the same time we are all faced with a world requiring our increased efficiency and attention.

So won’t checklists slow us down?

First, that may not be a bad thing. Slowing down means taking a second look and avoiding an oversight. Lots of psychological studies also show that we see what we expect to see. The popular show “Brain Games” right now reminds me of this each time I watch. But when you put a checklist in front of me, it re-centers me on core functions and ensures none of those are omitted.

We also have memories that can be influenced by our expectations. Believe it or not, there is evidence that we “mis-remember” (for fans of Roger Clemens)  what we’ve done many times, including things we consider basic, partially because they are so rote for us that we assume we’ve addressed them. So checklists step in and make you review those core principles.

But worklists can be made to work for you in other ways, helping to promote cost-effectiveness, and efficiency, not just safety. Ensuring that all needed tasks are taken care of before a study comes to you for a read means there are fewer times you view something not ready to read. And having an orderly efficient process in writing means there is no wasted effort or extra phone calls or notes. Last, risk managers (read: insurers) love them. They help document your process and avoid errors.

In short, checklists are good for safety and for your efficiency. Look into them. They are likely to cross your desk sooner rather than later.