title: Implementation of a standardized procedural checklist in a children's hospital.
abstract: BACKGROUND
  The aim of this study was to examine the implementation and sustainability of checklist use among procedural-based specialties in a pediatric hospital and to survey perceptions of checklist efficacy among staff members and physicians.
  
  
  METHODS
  A modified World Health Organization procedural checklist was implemented. Percentage daily compliance was collected for all procedures over a 12-month period. Clinical staff members participated in a survey regarding the checklist. Associations among gender, clinical role, and years of experience were evaluated.
  
  
  RESULTS
  Compliance at 12 months was significantly higher than at inception (94% vs 88%, P < .001) with average monthly compliance of 92%. Compliance deteriorated on weekends and holidays. Surgeons had more positive perceptions of using the checklist compared with nurses and anesthesiologists, independent of experience and gender (P = .001).
  
  
  CONCLUSIONS
  The implementation of a procedural checklist can be sustained across specialties with high compliance. Off-hours utilization remains problematic. Perceptions of checklist efficacy are disparate among roles in the operating room.
authors.affiliation: Department of Surgery, University of Washington, Division of Pediatric Surgery, Seattle Children's Hospital, Seattle, WA, USA. jeffrey.avansino@seattlechildrens.org
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Avansino
authors.forename: Patrick
authors.initials: P
authors.lastname: Javid
authors.forename: Cindy
authors.initials: C
authors.lastname: Katz
authors.forename: George
authors.initials: G
authors.lastname: Drugas
authors.forename: Adam
authors.initials: A
authors.lastname: Goldin
mesh_terms: D057189:Checklist / Q000592:standards*; D006776:Hospitals, Pediatric / Q000458:organization & administration*; D006801:Humans; D008505:Medical Staff, Hospital / Q000458:organization & administration*; D010865:Pilot Projects; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014481:United States