Barriers to the implementation of checklists in the office-based procedural setting
Version of Record online: 22 APR 2014
© 2014 American Society for Healthcare Risk Management of the American Hospital Association
Journal of Healthcare Risk Management
Volume 33, Issue 4, pages 35–43, 2014
How to Cite
Shapiro, F. E., Fernando, R. J. and Urman, R. D. (2014), Barriers to the implementation of checklists in the office-based procedural setting. J of Healthcare Risk Mgmt, 33: 35–43. doi: 10.1002/jhrm.21141
- Issue online: 22 APR 2014
- Version of Record online: 22 APR 2014
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.
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.
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%).
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.