Developing and assessing electronic checklists for safety mindfulness, workload, and performance

The aim of this study is to propose a set of innovative principles for the effective design of electronic checklists to enhance safety mindfulness (a specific safety mindful mindset that offers the opportunity to operate more preemptively during routine quality assurance tasks) and discuss some of our preliminary results from testing our proposed electronic checklist with dosimetrists and physicists.

A multidisciplinary team designed, developed, and evaluated the utility of the electronic checklist (vs paper-based checklist) to promote safety mindfulness. Subjective workload was measured at the end of each assessment/scenario. Performance was quantified on the basis of discovery of purposefully embedded errors, time to complete the scenario, and additional concerns that were documented by the participants.

Use of the electronic checklist was associated with decreases in time to scenario completion (P < .01) and increases in documentation of additional patient safety and plan quality concerns (P = .04) but had no significant impact on the recognition of purposefully embedded errors or perceptions of workload.

Our proposed principles for the design of electronic checklists may improve the efficiency of quality assurance procedures while enhancing users' safety mindfulness. Future research is needed to better understand the utility of our proposed design principles on patient safety from a long-term use perspective.