WHO cares? Safety checklists in echocardiography

The number of potentially preventable medical errors that occur has been steadily increasing. These are a significant cause of patient morbidity, can lead to life-threatening complications and may result in a significant financial burden on health care. Effective communication and team working reduce errors and serious incidents. In particular the implementation of the World Health Organisation (WHO) Safe Surgery Checklist has been shown to reduce in-hospital mortality, postoperative complications and the incidence of surgical site infection. However an increasing number of complex medical procedures and interventions are being performed outside of the theatre environment. The lessons learnt from the surgical setting are relevant to other procedures performed in other areas. For the echocardiographer, transoesophageal echocardiography (TOE) is one such procedure in which there is the potential for medical errors that may result in patient harm. This risk is increased if patient sedation is being administered. The British Society of Echocardiography and the Association of Cardiothoracic Anaesthetists have developed a procedure specific checklist to facilitate the use of checklists into routine practice. In this article we discuss the evolution of the WHO safety checklist and explore its relevance to TOE.