Articles: checklist.
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British dental journal · Mar 2013
ReviewWhy do GDPs fail to recognise oral cancer? The argument for an oral cancer checklist.
Delays in the diagnosis of oral cancer have been the subject of several cases recently reported in the media. Different types of delays include patient delays, doctor delays and system delays. Although diagnostic delays in primary care constitute a minority of these cases they are potentially modifiable and therefore an important aspect of care to address. ⋯ However several problems in fully assessing patients for oral cancer have been reported. These include time constraints, a lack of remuneration and little training in assessing risk factors and conducting a soft tissue examination. This article reviews these issues and puts forward the case for oral cancer detection as a compulsory CPD topic and a national oral cancer checklist as a tool to ensure all aspects of the oral cancer assessment are considered, which can then be audited and remunerated.
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Checklists are commonly proposed tools to reduce error. However, when applied by experts, checklists have the potential to increase cognitive load and result in 'expertise reversal'. One potential solution is to use checklists in the verification stage, rather than in the initial interpretation stage of diagnostic decisions. This may avoid expertise reversal by preserving the experts' initial approach. Whether checklist use during the verification stage of diagnostic decision making improves experts' diagnostic decisions is unknown. ⋯ Among ECG interpretation experts, checklist use during the verification stage of diagnostic decisions did not increase cognitive load or cause expertise reversal, but did reduce diagnostic error.
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Although a number of validated tools are available for assessing nontechnical skills and teamwork in the operating room (OR), there are no tools for measuring completion of key OR tasks, which is fundamental to effective teamwork, patient safety, and OR efficiency. This study describes the development and content validation of a new tool (ie, the Metric for Evaluating Task Execution in the Operating Room) for measuring basic task completion during surgical procedures. ⋯ The Metric for Evaluating Task Execution in the Operating Room is easy to use and can identify specific gaps in safety and/or efficiency in OR processes. Next, we should examine its links with additional measures of OR performance, for example, patient outcomes, list cancellations/delays, and nontechnical skills.