The problems of replicating the effects of patient-safety checklist trials in routine practice could be mitigated by adapting checklists for individual hospital environments and teams (see Nature 523, 516–518; 2015). An F-16 fighter aircraft would not rely on a checklist devised for flying a jumbo jet.
For instance, much of the World Health Organization's surgical safety checklist is irrelevant to a cardiac catheterization procedure. There is no general anaesthetic or expected blood loss, for example, but monitoring kidney function is crucial. We therefore designed a bespoke safety checklist to brief the cardiac clinical team on the planned procedure and on any potential problems. Endorsed by the British Cardiovascular Society (www.bcs.com/checklist), the checklist is regularly modified in response to end-user evaluation.
Smart electronic checklists will further improve safety by highlighting patient-specific risks and acting as a guide in emergencies and for auditing near-misses.