The use of a checklist in a pediatric oncology clinic.

BACKGROUND: Errors and near misses are common in medicine. Checklists and similar interventions are feasible and can reduce the incidence of errors and improve patient outcomes. This study assessed the feasibility and efficacy of a checklist in a pediatric oncology clinic. PROCEDURE: Errors and near misses of all types were systematically tracked for 1 month in a pediatric oncology clinic. Following the initial 1 month time period (baseline), a 10-item checklist was implemented for each patient encounter during a 4-month period. During month 5 of the study while the checklist was being used, errors and near misses were again systematically tracked for 1 month.
RESULTS: The use of a checklist was associated with a significant reduction of errors in our clinic. The total number of errors (including documentation errors) decreased from 133 in month 1 to 39 in month 5 (P < 0.0001). In addition, checklist use decreased the rate of encounters with at least one error from 34% to 15% (P < 0.001). The reduction in errors occurred despite the checklist not being used for each encounter. The majority of practitioners were satisfied with the use of a checklist and think that the use of a checklist is a good way to reduce errors.
CONCLUSIONS: A checklist is potentially a feasible, safe, inexpensive, and simple method to lower the rate of medical errors in a pediatric oncology clinic.