Postprocedure Checklist Reduces Adverse Events in IR Procedures

 

A study published July 5 in the Journal of Vascular and Interventional Radiology shows that a postprocedure checklist substantially reduces the risk of adverse effects and repeat procedures after interventional radiology procedures.

Researchers at Boston’s Beth Israel Deaconess Medical Center sought to discover ways to improve patient safety and outcomes during and after interventional radiology procedures. Dr. Bettina Siewert led the study group.

The facility’s radiology quality committee designed a postprocedure closeout checklist after studying adverse events that followed procedural service lines — including interventional and vascular radiology procedures, breast imaging, musculoskeletal, and neuroradiology.

The institution began using the postprocedure closeout checklist on November 1, 2016. Researchers recently compared the number of adverse events annually, starting with the years before 2015-2016 and comparing them to the years after the checklist was implemented (2017-2021).

The results were statistically significant for both adverse events and repeat procedures.

	Adverse Events Before Checklist Utilization	Adverse Events After Checklist Utilization	Percentage of Improvement
Adverse Events	0.069%	0.034%	43%
Repeat Procedures	0.04%	0.007%	80%
Incidents Annually	18.5 per year	8 per year	58%

 

An audit for compliance showed overall excellent compliance rates — 94.2%-99.6%. A not-unexpected exception occurred among the patients with adverse events, with compliance rates at only 60%. The researchers noted that some procedural errors were errors that would not have been prevented if the checklist had been utilized, errors in orders and specimen mismatch, incomplete orders, or incorrect patient label on the form. Researchers note that approximately 70% of those errors can be avoided in the future by revising the postprocedure checklist.

The Radiological Society of North America (RSNA) reports that checklists are especially effective in surgical procedures, and the World Health Organization has developed the Interventional Radiology Patient Safety Screening, designed for ease of use by IR departments. Full utilization of checklists may not be completely utilized until there are organizational and cultural changes — lack of awareness and training and emphasis on efficiency continue to present challenges.

The Beth Israel Deaconess Medical Center study presents solid evidence that checklist utilization in interventional radiology not only helps prevent human error but helps create a culture and environment that promotes patient safety every day.