Utility of preprocedure checklists in the congenital cardiac catheterization laboratory.

OBJECTIVE Preprocedure meetings have become more commonplace in medicine but are not performed routinely in the cardiac catheterization laboratory. We sought to create, implement, and evaluate a preprocedural meeting in the form of a checklist for the cardiac catheterization laboratory. Staff attitudes and perceptions toward safety and sense of teamwork were also analyzed. DESIGN All procedures performed in the cardiac catheterization laboratory on patients with structural heart disease from January 2010 to February 2012 were retrospectively reviewed for demographics, procedural details, and reported complications. A checklist was introduced to the preprocedure protocol at the halfway point, and patients were divided into pre- and postchecklist cohorts. Anesthesia and cardiac catheterization laboratory staff were surveyed at the beginning and end of the study period regarding attitude toward safety, team climate, and the impact of errors. RESULTS Total number of procedures (prechecklist, n = 371; postchecklist, n = 370) and demographics were similar among groups. Complication rates were equivalent pre- and postchecklist, but there was a greater proportion of interventional cases and higher median complication level in the postchecklist group. Cardiac catheterization laboratory staff reported improved awareness of being briefed with the checklist. Anesthesia differed from cardiac catheterization staff in perception of communication as well as team and safety climate. CONCLUSIONS A preprocedure checklist for congenital cardiac catheterization cases is easy to perform and serves to update cardiac catheterization laboratory staff. Anesthesia and cardiac catheterization staff had different perceptions of safety and teamwork climate. Further studies are needed to determine if this briefing could lead to better communication among services and ultimately reduce complications.