Standards of neurosurgical procedures

Written specifications with regard to procedures performed, equipment used, and training of the involved personnel are widely used in the industry and aviation to guarantee constant quality. Similar systems are progressively being introduced to medicine. We have made an effort to standardize surgical procedures by introducing step-by-step guidelines and checklists. The current experience shows that a system of written standards is applicable to neurosurgery and that the use of checklists contributes to the prevention of forgetting essential details. Written standards and checklists are also a useful training tool within a university hospital and facilitate communication of essentials to the residents. Comparison with aviation suggests that standardization leads to a remarkable but nonetheless limited reduction of adverse incidents.