Managerial Challenges in the Clinical Use of Checklists: Proven Benefits, Yet Untapped Potential?

Area of Science:

• Healthcare Management
• Patient Safety Research
• Surgical Quality Improvement

Background:

• Surgical safety checklists are proven to reduce adverse events.
• Inconsistent implementation limits real-world effectiveness.
• Managerial barriers impede optimal checklist utilization.

Purpose of the Study:

• Investigate managerial barriers to effective surgical safety checklist use.
• Focus on organizational structure, workplace culture, and staff attitudes.
• Identify factors hindering consistent checklist implementation across surgical subspecialties.

Main Methods:

• Semi-structured interviews with section and clinic managers at two Norwegian university hospitals.
• Inclusion of participants with nursing and medical backgrounds.
• Analysis of perceptions and challenges in integrating checklists into daily surgical practice.

Main Results:

• A significant gap exists between surgical safety checklist policy and practice.
• Checklist use is rarely monitored or discussed across managerial levels.
• Fragmented communication and systemic barriers, like competing priorities, hinder effective checklist integration.

Conclusions:

• Hospitals need a more adaptive and reflective safety culture to improve patient safety.
• Integrating checklist use into governance frameworks is crucial.
• Establishing mechanisms for monitoring, feedback, and continuous learning is essential for effective checklist implementation.