When it comes to checklist implementation, it is important to recognise that aviation checklists are integral to the normal workflow. The aircraft does not stop while the checklist is completed, and the timing of checklist completion is arranged so that it does not conflict with other essential flight activities. To that end, the checklist does not impose an additional burden or workload, but is actually perceived by aircrew as something that makes the flight easier. In contrast, the Time Out is performed before the case can begin, so essentially stands independently of the workflow. To that end, the Time Out is likely to be seen as something additional, and, unless it results in obvious time-saving downstream, will be perceived as an increase in workload. This mixture of purpose between checklist and briefing, in combination with implementation issues, may explain the range of outcomes as well as the range of enthusiastic to skeptical opinions about the mandated use of checklists in surgery.14–16


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Everything seemed fine, until the patient stopped responding and his heart rate skyrocketed. The patient's blood pressure was barely detectable. Nothing his medical team did improved it, so he was rushed to surgery. Only when he was opened up did the doctor finally realize the stab wound went much further inside the patient than he'd thought, cutting right into the aorta—the main artery from the heart. Although it seemed like a small knife wound, the patient had actually been struck by a bayonet—part of the assailant's costume.
NO, I don’t. I call them “to do” lists. LOL! They’re very helpful, they keep me sane and keep stress away. For many years now, I keep a daily list prepped the night before; and a weekly list that’s prepped every Sunday. Keeps things smooth-sailing all the time. So at the end of the day, if all items are crashed-out (as in “done”!), I feel so good about myself. :)
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