Checklists in Neurosurgery to Decrease Preventable Medical Errors: A Review

Abstract

Neurosurgery represents a zero tolerance environment for medical errors, especially preventable ones like all types of wrong site surgery, complications due to the incorrect positioning of patients for neurosurgical in-terventions and complications due to failure of the de-vices required for the specific procedure.Following the excellent and encouraging results of the safety checklists in intensive care medicine and in oth-er surgical areas, the checklist was naturally introduced in neurosurgery. To date, the reported world experience with neurosurgical checklists is limited to 15 series with fewer than 20,000 cases in various neurosurgical areas.The purpose of this review was to study the reported neurosurgical checklists according to the following pa-rameters: year of publication; country of origin; area ofneurosurgery;typeofneurosurgicalprocedure-elective or emergency; person in charge of the check-list completion; participants involved in completion; whether they prevented incorrect site surgery; whether they prevented complications due to incorrect posi-tioning of the patients for neurosurgical interventions; whether they prevented complications due to failure of the devices required for the specific procedure; their specific aims; educational preparation and training; the time needed for checklist completion; study duration and phases; number of cases included; barriers to im-plementation; efforts to implementation; team appre-ciation; and safety outcomes.Based on this analysis, it could be concluded that neu-rosurgical checklists represent an efficient, reliable, cost-effective and time-saving tool for increasing pa-tient safety and elevating the neurosurgeons' self-con-fidence. Every neurosurgical department must develop its own neurosurgical checklist or adopt and modify an existing one according to its specific features and needs in an attempt to establish or develop its safety culture. The world, continental, regional and national neurosurgical societies could promote safety checklists and their benefits.