PHASE Checklist

Handoff Checklists for Surgical Patients

Surgical safety and anesthesia safety checklists have been proven to reduce mishaps and improve outcomes. Checklists haves also been used to improve the conduct of handoffs and to guide treatment during crises. However, executing checklists in a uniform, reproducible and reliable manner can be difficult. Checklist posters on the procedure room wall can be challenging or impossible to read at a distance, and paper checklists get misplaced. Checklists incorporated into electronic health records are often simple lists, without “smart” functionality. Computerized checklists are widely used in commercial aviation, either built in to the avionics systems, or carried onto the flight deck by the pilots on their ubiquitous computer tablets. The format and function of these computerized checklists have been carefully considered, designed and refined by aircraft manufacturing companies, airlines and test pilots. The authors of this app are anesthesiologists, software engineers, and a commercial airliner test pilot. They have incorporated aviation checklist design principles into this convenient app. Key design elements include ease of navigation, the ability to quickly identify the checklist that is required for a particular situation, a place keeper that automatically highlights the next checklist item, a change in color when checklist items are completed, a change in color of checklist items that are skipped, helping to prevent missed checklists items, which can be a cause of mishaps, and confirmation that a checklist has been completed. In addition to a brief and easily recognized description of each checklist item, a more detailed explanation of each item is also available for reference. In this inaugural version of the app, a limited library of checklists is provided, that will eventually be expanded to include many more checklists, including a full suite of crisis checklists (known as “non-normal checklists” in aviation). Current checklists include—

Operating room to intensive care unit handoff

Intensive care unit of operating room handoff

Operating room to postoperative recovery unit handoff

Operating room anesthesia provider to anesthesia provider handoff