Implementation of a standardized procedural checklist in a children's hospital

Am J Surg. 2011 May;201(5):660-5. doi: 10.1016/j.amjsurg.2011.01.014.


Background: The aim of this study was to examine the implementation and sustainability of checklist use among procedural-based specialties in a pediatric hospital and to survey perceptions of checklist efficacy among staff members and physicians.

Methods: A modified World Health Organization procedural checklist was implemented. Percentage daily compliance was collected for all procedures over a 12-month period. Clinical staff members participated in a survey regarding the checklist. Associations among gender, clinical role, and years of experience were evaluated.

Results: Compliance at 12 months was significantly higher than at inception (94% vs 88%, P < .001) with average monthly compliance of 92%. Compliance deteriorated on weekends and holidays. Surgeons had more positive perceptions of using the checklist compared with nurses and anesthesiologists, independent of experience and gender (P = .001).

Conclusions: The implementation of a procedural checklist can be sustained across specialties with high compliance. Off-hours utilization remains problematic. Perceptions of checklist efficacy are disparate among roles in the operating room.

Publication types

  • Comparative Study

MeSH terms

  • Checklist / standards*
  • Hospitals, Pediatric / organization & administration*
  • Humans
  • Medical Staff, Hospital / organization & administration*
  • Pilot Projects
  • Retrospective Studies
  • Surveys and Questionnaires*
  • United States