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Highly Accessed Review

Clinical review: Checklists - translating evidence into practice

Bradford D Winters1, Ayse P Gurses2, Harold Lehmann3, J Bryan Sexton24, Carlyle Jai Rampersad5 and Peter J Pronovost24*

Author Affiliations

1 Departments of Anesthesiology and Critical Care Medicine, The Johns Hopkins University, 600 N. Wolfe Street, Meyer 299, Baltimore, MD 21287, USA

2 Departments of Anesthesiology and Critical Care Medicine, The Johns Hopkins University, 1909 Thames Street, 1st floor, Baltimore, MD 21231, USA

3 Departments of Pediatrics and Welch Health Sciences Informatics, The Johns Hopkins University, 2024 E. Monument Street, 1-201, Baltimore, MD 21205, USA

4 Department of Health Policy and Management, The Johns Hopkins University, 1909 Thames Street, 2nd floor, Baltimore, MD 21231, USA

5 US Airways, Philadelphia International Airport, Terminal B, Philadelphia, PA 19153, USA

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Critical Care 2009, 13:210  doi:10.1186/cc7792

Published: 31 December 2009

Abstract

Checklists are common tools used in many industries. Unfortunately, their adoption in the field of medicine has been limited to equipment operations or part of specific algorithms. Yet they have tremendous potential to improve patient outcomes by democratizing knowledge and helping ensure that all patients receive evidence-based best practices and safe high-quality care. Checklist adoption has been slowed by a variety of factors, including provider resistance, delays in knowledge dissemination and integration, limited methodology to guide development and maintenance, and lack of effective technical strategies to make them available and easy to use. In this article, we explore some of the principles and possible strategies to further develop and encourage the implementation of checklists into medical practice. We describe different types of checklists using examples and explore the benefits they offer to improve care. We suggest methods to create checklists and offer suggestions for how we might apply them, using some examples from our own experience, and finally, offer some possible directions for future research.