Surgical Checklists Unused in 10% of Hospitals, CMS Data Shows

HealthLeaders recently published a disturbing article about new data available on the Centers for Medicare & Medicaid Services' (CMS) Hospital Compare website.  Given the evidence of how surgical checklists can reduce deaths and complications, it's a mystery why nearly 10% of hospitals still don't mandate their use and why another 12% can't say for certain whether or not checklists are being used.

One week ago, the CMS Hospital Compare website started publically reporting which of 4,136 hospitals across the country use surgical checklists and which ones don't.

That, one would think, is a pretty big deal, introducing a level of transparency that would please Brigham & Women's Hospital surgeon Atul Gawande to no end. Gawande's work has shown that a Safe Surgery Safety Checklist can reduce by up to one-third deaths and complications resulting from retained objects, infections, unplanned reoperations, and other procedural horrors such as wrong-site or, heaven forbid, wrong-person surgery.

Amazingly, despite so much evidence showing the importance of using such checklists, the website shows that, for the calendar year 2012 when the reports were collected, 366 hospitals said they still don't use them and 497 couldn't say whether they did or not.

Specifically, CMS is now reporting on whether hospitals use a 12-point version of the checklist, one that stops everything at three "critical points" of an operation: before anesthesia, before skin incision, and after surgical site closure but before the patient leaves the operating room.