Veterinary Medicine Needs Checklists

In the Literature

Oxtoby C, Mossop L. Implementing checklists in practice. In Pract. 2016;38(9):463-464.

The Research …

In this review of the practical implications of checklists in the veterinary setting, the authors make the case for checklists from a patient safety perspective and offer tips for getting started, such as where to source checklists. The article also proposes a potential framework for checklist implementation, broken down into stages, and a summary of the barriers practices should prepare to face during implementation.

… The Takeaways

Key pearls to put into practice:

1. Checklists in healthcare (modeled after the preflight safety checklists of the airline industry and popularized by Atul Gawande’s Checklist Manifesto) have become widely adopted in the human medical industry but anecdotally remain in their infancy in the veterinary setting.¹ Checklists can be leveraged for many clinical scenarios, including surgery, anesthesia, dentistry, emergency cases (eg, trauma,² toxin ingestion), or routine appointments (eg, senior wellness, vaccinations).

2. Be able to articulate the “why” with veterinary teams by knowing and being able to explain the facts. Medical errors may be more widespread than realized, especially without formal adverse event reporting. Checklists are a simple, free, easy, and proven way to save lives and prevent patient suffering, and they make veterinary teams more efficient through better communication and morale, improved preparation, and reduced equipment breakdowns. Checklists prevent medical errors and thus preserve the veterinary team’s financial and emotional well-being.

3. Do not reinvent the checklist wheel. Checklist design can be a formidable process, but several reputable organizations provide templates that are built to be modified, including checklists for human medical settings that can be applied to veterinary practice. Some organizations that freely publish clinical checklists include Clinician’s Brief, the World Health Organization, the Association of Veterinary Anaesthetists, the Animal Health Trust, and the Institute for Healthcare Improvement (see Suggested Reading).

4. Follow a process. Workflow changes should be implemented carefully with an outline of steps to implementation. Start with a practice meeting explaining the reason for the initiative, appoint a medical supervisor to oversee the checklist project, and try the checklist in one area of the practice first. The final stage of any checklist implementation project should include scheduled time to reassess, modify, and discuss results.