Checklists Improve Team Performance During Simulated Extracorporeal Membrane Oxygenation Emergencies: A Randomized...

Area of Science:

• Medical Simulation
• Patient Safety
• Critical Care Medicine

Background:

• Extracorporeal membrane oxygenation (ECMO) complications can be catastrophic and require rapid intervention.
• Due to the rarity of complications, high-fidelity simulation is crucial for training ECMO specialists.
• Standardized checklists are proposed to enhance team performance during critical ECMO events.

Purpose of the Study:

• To test the hypothesis that standardized checklists improve team performance during simulated ECMO emergencies.
• To evaluate the impact of checklists on critical task completion and team coordination.

Main Methods:

• A randomized simulation-based trial was conducted at a quaternary-care academic hospital.
• Six read-do checklists were developed using a modified Delphi process for ECMO emergencies.
• Teams of 2-3 providers were randomized to use checklists or not, completing four simulated emergencies.

Main Results:

• Checklist groups completed significantly more critical tasks (90% vs. 75%; p < 0.001).
• Higher proportions of nontechnical (71% vs. 44%; p < 0.001) and technical (94% vs. 86%; p < 0.001) tasks were performed by checklist groups.
• No significant differences in time-to-completion were observed between groups.

Conclusions:

• The implementation of checklists demonstrably improved team performance in simulated ECMO emergencies.
• Checklists represent a valuable, low-cost intervention for reducing errors and improving crisis management in ECMO.
• This strategy is particularly relevant as ECMO utilization continues to grow.