The Impact of Surgical Checklists in Dentistry

Patient safety is a fundamental requirement for effective care in dental and medical settings.¹ In 2008, the World Health Organization published the WHO Surgical Safety Checklist and Implementation Manual.² Based on these guidelines, Haynes et al³ designed a surgical checklist. After its introduction, they reported the rate of complications at all sites dropped from 11.0% at baseline to 7.0%, and the total in-hospital rate of death dropped from 1.5% to 0.8%. Following this, surgical checklists have been implemented in more than 4000 hospitals worldwide.⁴

A systematic review by Treadwell et al⁵ notes that surgical checklists reduced complications and improved communication between operating staff. In another systematic review, Boyd et al6 reviewed randomized controlled trials involving checklists. The investigation pointed to their effectiveness in improving safety outcomes in hospitalized patients. The team reported significant reductions in postoperative complications and medication-related problems, as well as improved compliance with evidence-based prescribing and infection control protocols.⁶

In dentistry, checklists have been developed for use in endodontic treatment, dental implant placement, early identification of malignancy presenting as temporomandibular disorder (TMD), and to prevent the extraction of wrong teeth. Christman et al⁷ designed a checklist to aid in reducing errors in the placement of dental implants especially for inexperienced practitioners, dental students, surgical residents and dental implant trainees. Similarly, Bidra⁸ described a perioperative surgical safety checklist that could be used by clinicians of varying experience for straightforward and/or complex implant and related surgeries in an outpatient setting, without sedation. Beddis et al⁹ developed a checklist for patients presenting to the TMD clinic with trismus. The team reported that use of the checklist improved early recognition of atypical features presenting with trismus and contributed to the early diagnosis of a case of malignancy.

References

1. Campbell S, Tickle M. What is quality primary dental care? Br Dent J. 2013;215:135–139.
2. World Health Organization. WHO Surgical Safety Checklist and Implementation Manual.
3. Haynes AB, Weiser TG, Berry WR, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med. 2009;360:491–499.
4. Pugel AE, Simianu VV, Flum DR, Dellinger PE. Use of the surgical safety checklist to improve communication and reduce complications. J Infect Public Health. 2015;8:219–225.
5. Treadwell JR, Lucas S, Tsou AY. Surgical checklists: a systematic review of impacts and implementation. BMJ Qual Saf. 2014;23:299–318.
6. Boyd J, Wu G, Stelfox H. The impact of checklists on inpatient safety outcomes: a systematic review of randomized controlled trials. J Hosp Med. 2017;12:675–682.
7. Christman A, Schrader S, John V, Zunt S, Maupome G, Prakasam S. Designing a safety checklist for dental implant placement: a Delphi study. J Am Dent Assoc. 2014;145:131–140.
8. Bidra AS. Surgical safety checklist for dental implant and related surgeries. J Prosthet Dent. 2017;118:442–444.
9. Beddis HP, Davies SJ, Budenberg A, Horner K, Pemberton MN. Temporomandibular disorders, trismus and malignancy: development of a checklist to improve patient safety. Br Dent J. 2014;217:351–355.

This information originally appeared in Gandhi KK, John V. Implementing periodontal surgical checklists. Decisions in Dentistry. 2020;6(10):10-12.