Error reduction with routine checklist use during deep brain stimulation surgery.
BACKGROUND
The use of checklists to reduce error rates in procedural literature has led our group to employ this strategy during deep brain stimulation (DBS) surgery.


OBJECTIVE
We sought to examine the improvement in the number of errors made during DBS surgery after long-term use of a checklist.


METHODS
Our checklist has been used for all DBS cases at our institution since the beginning of this study's enrollment in 2008. The number of cases in which errors were detected after 1 year of routine use (group B, n = 11) was compared in one cohort of DBS subjects to that of an earlier cohort of patients (group A, n = 17), which underwent DBS exactly 1 year prior.


RESULTS
Eleven of the 14 cases where major errors were detected occurred in group A; 6 of the 9 cases where only minor errors were detected were also in group A; of the patients without any error, all 5 were in group B. We found a significant difference in these proportions between group A and group B [χ(2)(2) = 9.73; p < 0.008].


CONCLUSIONS
After 1 year of checklist use, the total number of major and minor errors made was reduced, indicating an improvement in error rate after long-term routine incorporation of this checklist.
University of Pennsylvania, Center for Functional and Restorative Neurosurgery, Pennsylvania Hospital, Philadelphia, PA 19106, USA.
Daniel R
DR
Kramer
Casey H
CH
Halpern
Patrick J
PJ
Connolly
Jurg L
JL
Jaggi
Gordon H
GH
Baltuch
D057189:Checklist; D046690:Deep Brain Stimulation / Q000379:methods*; D004567:Electrodes, Implanted; D020329:Essential Tremor / Q000601:surgery*; D006801:Humans; D010300:Parkinson Disease / Q000601:surgery*; D020531:Subthalamic Nucleus / Q000601:surgery*; D013788:Thalamus / Q000601:surgery*; D016896:Treatment Outcome