How wrong can an assumption be? My piece last week assumed that those doyens of evidence-based practice – surgeons – always get the basics right, only to read 5 days later (in a fascinating article) that even they have to be prompted by a list of very simple and obvious checks. So why shouldn’t EB managers have their own checklist based on the same, evidence-based thinking? What better place to start than the WHO (World Health Organization) ‘Surgical Safety Checklist’ as a template.
But before you try to use it you might want to take note from a related piece in 2010 in the British Medial Journal –
“Use of the checklist will require a change in culture for operating theatre teams, and the benefits will be realised only if everyone is supportive of the change and implementation is robust.”
Introducing even the simplest changes to established practice represents a huge challenge. The practices that we take for granted today were often regarded as revolutionary, when they were first introduced, and invariably faced stiff opposition from the prevailing ‘establishment’. It was many years before simple disinfection techniques were widely accepted and evidence-based management is going to require a similar culture shift.
I have to admit though that I have never been a fan of checklists, especially the tick-box variety often applied in the field of human resource management (e.g. did you complete all your performance appraisals last year?). My thinking went along the lines of – how can you have a checklist to deal with human beings who are all unique individuals? I’m still confident that holds true when you are trying to help people reach their full potential but we often forget that it is the mundane, yet crucial, tasks that often get overlooked in the process. EB Managers should never forget that getting the basics right is the only gateway to the more interesting and exciting stuff.
How you might attempt to bring about the required culture change will be the subject of a later EBM Lesson but in the meantime you could become acquainted with and proficient at following the EBM Checklist. As you try it out you are also invited to suggest any improvements.