Commentary: A checklist is nothing without simulation training and collaborative culture

Abstract

Central MessageChecklists are an essential safety tool; however, they must be implemented together with other instruments such as simulation programs and a culture of error reporting to prevent mistakes.See Article page 71. Checklists are an essential safety tool; however, they must be implemented together with other instruments such as simulation programs and a culture of error reporting to prevent mistakes. See Article page 71. I have carefully reviewed this article, and I must congratulate the authors because their manuscript gives us the opportunity to reflect on some extremely interesting topics.1Bushra R. Ahmadi N. Pradeep S. Hamad S. Coonar A. Extraction of unexpectedly retained wire after endobronchial ultrasound.J Thorac Cardiovasc Surg Tech. 2022; 11: 71-73Scopus (1) Google Scholar In itself, the clinical case is not particularly rare because, although the foreign body was of an iatrogenic nature, the removal method is entirely consistent with traditional rigid bronchoscopy procedures. The type of foreign body—the wire of the biopsy needle—is unusual and can certainly help to remind operators to be extra vigilant during procedures. However, I very much appreciated the article in its conclusions when the authors introduce periprocedure checks as an instrument to prevent errors. To gauge the extent of the problem, it is enough to consider that “Over 200 million surgical procedures are performed each year globally, and despite awareness of adverse effects, surgical errors continue to occur at a high rate. Surgical errors account for a significant number of adverse events.”2Christensen M. Lundh A. Medication review in hospitalised patients to reduce morbidity and mortality.Cochrane Database Syst Rev. 2016; 2: CD008986PubMed Google Scholar But why are errors made during surgery? According to the 2017 National Healthcare Quality and Disparities Report, mistakes during surgery develop from the interaction of multiple individuals and pieces of equipment. To decrease surgical errors, providers need to know when and where mistakes may occur. It is common experience that to prevent surgical errors and enhance patient safety, hospitals have introduced several checklists of items that must be verified prior, during, and after procedures. In 2014, Collins and colleagues3Collins S.J. Newhouse R. Porter J. Talsma A. Effectiveness of the surgical safety checklist in correcting errors: a literature review applying Reason's Swiss cheese model.AORN J. 2014; 100: 65-79.e5Crossref PubMed Scopus (49) Google Scholar well described surgical safety checklists as being a successful intervention in reducing the recurrence of errors in the operating room. However, checklists alone will not prevent all mistakes. Indeed, fundamental requirements for successful implementation include the engagement of key stakeholders, a culture of trust, a shared vision for safety, and active communication. In this regard, I suggest reading articles by Rinieri and colleagues,4Rinieri P. Selim J. Le Guillou V. Baste J.M. Crisis checklist (Code Red) for the management of cardiac arrest during minimally invasive thoracic surgery: case report.J Cardiothorac Surg. 2020; 15: 173Crossref PubMed Scopus (1) Google Scholar Baste and colleagues,5Baste J.M. Bottet B. Selim J. Sarsam M. Lefevre-Scelles A. Dusseaux M.M. et al.Implementation of simulation-based crisis training in robotic thoracic surgery: how to improve safety and performance?.J Thorac Dis. 2021; 13: S26-S34Crossref PubMed Google Scholar and Dixon and colleagues.6Dixon J.L. Mukhopadhyay D. Hunt J. Jupiter D. Smythe W.R. Papaconstantinou H.T. Enhancing surgical safety using digital multimedia technology.Am J Surg. 2016; 211: 1095-1098Abstract Full Text Full Text PDF PubMed Scopus (12) Google Scholar The authors concur that checklists need to be implemented with other tools and describe how they successfully established at their institutions a comprehensive simulation program with crisis resource management and th