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Barriers to the implementation of checklists in the office‐based procedural setting
Author(s) -
Shapiro Fred E.,
Fernando Rohesh J.,
Urman Richard D.
Publication year - 2014
Publication title -
journal of healthcare risk management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.221
H-Index - 16
eISSN - 2040-0861
pISSN - 1074-4797
DOI - 10.1002/jhrm.21141
Subject(s) - checklist , patient safety , mandate , medicine , agency (philosophy) , incentive , medical emergency , health care , protocol (science) , interim , nursing , business , family medicine , psychology , alternative medicine , philosophy , archaeology , epistemology , pathology , political science , law , economics , cognitive psychology , history , microeconomics , economic growth
Background Patient safety is critical for the patients, providers, and risk managers in the office‐based procedural setting, and the same standard of care should be maintained regardless of the healthcare environment. Checklists may improve patient safety and potentially decrease risk. This study explored utilization of checklists in the office‐based setting and the potential barriers to their implementation. Methods A cross‐sectional prospective study was performed by using a 19‐question anonymous survey designed with REDCap®. Medical providers including physicians and nurses from 25 different offices that performed procedures participated, and 38 individual responses were included in the study. Results Only 50% of offices surveyed use safety checklists in their practice. Only 34% had checklists or equivalent protocol for emergencies such as anaphylaxis or failed airway. As many as 23.7% of respondents indicated that they encountered barriers to implementing checklists. The top barriers identified in the study were no incentive to use a checklist (77.8%), no mandate from a local or federal regulatory agency (44.4%), being too time consuming (33.3%), and lack of training (33.3%). Reasons identified that would encourage providers to use checklists included a clear mandate (36.8%) and evidence‐based research (26.3%). Conclusions Checklists are not being universally utilized in the office‐based setting. There are barriers preventing their successful implementation. Risk managers may be able to improve patient safety and decrease risk by encouraging practitioners, possibly through incentives, to use customizable safety checklists.