Checking the lists: A systematic review of electronic checklist use in health care

We conducted a literature search to examine the effects and experiences surrounding the transition from paper to electronic checklists in healthcare settings. We explore the types of electronic checklists being used in health care, how and where they were evaluated and seek to identify the successes and failures of using electronic checklists in healthcare, including use of checklists to ensure completeness of documentation in the electronic medical record.

Formalized checklist use as a memory and decision aid in aviation has resulted in significant increases in safety in that domain. Checklists have also been successfully introduced to reduce errors in some areas of healthcare; however, in some contexts checklists failed to provide some of the expected benefits. Adapting and integrating checklists electronically into the healthcare workflow provides opportunities and challenges that need to be better understood to make checklist adoption a success in health care.

We conducted a literature search of the English language literature in MEDLINE using PubMed for peer-reviewed literature of implementation and use of electronic or computerized checklists related to clinical or healthcare use. We reviewed the studies and included in this review those papers that discussed in depth the development process and that conducted controlled studies to assess the effectiveness of checklists and the evaluation of their acceptance in the clinical context.

The literature search using the keywords electronic checklist OR computerized checklist returned a total of 23 peer-reviewed papers. Out of these 15 were included in the review, with 8 excluded because they did not evaluate checklist use for patient care.

More rigorous application of known principles and methods from Human Computer Interaction research and the behavioral sciences can provide a clearer, more comprehensive understanding of the conditions that affect the development and use of checklists.