A Checklist to Improve Patient Safety In Interventional Radiology
A study has shown a drop in the rate of adverse events from 24 per cent to 5 per cent, post checklist implementation.A recent study done by the World Health Organisation has shown that nearly 1 out of every 10 patients admitted to a hospital experience an adverse event. Half of the adverse events are related to invasive procedures such as surgical procedures, endoscopy, or radiological interventions. The need for improvements in patient safety and quality is increasingly being recognised. Recently, the World Health Organisation has introduced a safety checklist in the operating room that reduces the rates of death and complications associated with surgery. Because Interventional Radiology shares several features with surgery, a checklist may be equally effective to improve patient safety in Interventional Radiology (IR). Several checklists are available for use during radiologic interventions, including the RADPASS checklist, CIRSE IR Patient Safety Checklist, and the National Patient Safety Agency WHO Surgical Safety Checklist for Radiologic Interventions. Radiological Patient Safety System (RADPASS) is a checklist which was recently published by Cardiovascular and Interventional Society of Europe.
A checklist that is too complex, may affect task performance negatively, and unnecessarily complicate processes, but a checklist with very few items may omit critical components. The IR environment is fast-paced with a wide variety of cases and diverse patient population.
Checklist: What It Includes?
The goal behind performing safety checks is not to simply create a checklist, but to foster an environment of continuous safety into daily practice. This requires everyone, including physicians, nurses, and technologists, to accept and get involved with the change. These checklists cover all stages of the pathway for IR procedures (planning, preparation, and day-of-treatment and post-procedural care). These lists may disclose patient allergies, use of contrast agent, prophylactic antibiotics, sedation plan, laboratory values, need for blood products, review of prior imaging, specimen collection, radiation or magnetic resonance (MR) imaging safety precautions, need for special medications or equipment, additional safety concerns, and non-standard items for review. For example, the most common agents responsible for anaphylactic reactions during surgical and medical procedures are muscle relaxants and latex, followed by antibiotics and induction agents. The major emphasis on managing a patient’s allergies is prevention.
Importance Of Electronic Checklists
In an era of fully electronic medical records, we encourage the use of electronic checklists for several reasons.
- Default patient information can be loaded before the start of the case to help streamline operations.
- Data can be linked and tracked for future reference, such as a patient’s prior radiation exposure.
- Electronic checklists may help reduce paper checklist errors, as demonstrated in the aviation industry.
It is essential that the checklists are allowed to evolve in the course of time based on the changes in the items needed to address specific issues faced in IR. Feedback and experiments to improve the checklist are necessary to validate and assess the usefulness of the checklist in regard to patient outcomes.
Awareness of patient safety in radiology has risen over the last decade through analysis of incidents, and the adoption of the checklist will drastically reduce the adverse events while using IR in the future.
Dr M C Uthappa is Director, Interventional Radiology & Interventional Oncology at Gleneagles Global Hospitals. He is also a health council member at healthhunt.