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Variation in practice among resident physicians is a barrier to providing consistent, high-quality care to patients with musculoskeletal injuries. Materials and methods: A multidisciplinary group at an academic center developed a checklist for managing suspected extremity injuries in adults. Simulation testing was conducted in which 17 Emergency Medicine residents were randomized by year of training into cohorts of 8 “checklist” residents and 9 “no checklist” residents. Each resident performed 2 case simulations and was evaluated based on adherence to 12 predefined critical process measures. Results: Usage of the checklist resulted in a decrease in delay of care events (8.3 vs 27.3%, p < 0.01) and decrease in potential medical errors (5.7 vs 22.2%, p < 0.01). All levels of training demonstrated improvements, and first-year residents using the checklist performed significantly better than thirdyear residents without the checklist, demonstrating decrease in delay of care events (8.3 vs 26.4%, p < 0.05) and decrease in potential medical errors (5.6 vs 18.1%, p < 0.05). Conclusion: Implementation of a simple checklist can reduce delays in care and potential medical errors in the management of extremity injuries by resident physicians.

Management of Extremity Injuries by Residents: Can We improve Quality and Efficiency through a Simple Checklist?