• Edward W Petrik, Dennis Ho, Maqsood Elahi, Timothy R Ball, Michael P Hofkamp, Hania Wehbe-Janek, William C Culp, and Frank J Villamaria.
• Department of Anesthesiology, Scott & White Memorial Hospital, The Texas A&M University Health Sciences Center College of Medicine, Temple, TX.
• J. Cardiothorac. Vasc. Anesth.. 2014 Dec 1;28(6):1484-9.

ObjectiveSeparation from cardiopulmonary bypass (CPB) requires multiple preparatory steps, during which mistakes, omissions, and human errors may occur. Checklists have been used extensively in aviation to improve performance of complex, multistep tasks. The aim of this study was to (1) develop a checklist using a modified Delphi process to identify essential steps necessary to prepare for separation from CPB, and (2) compare the frequency of completed items with and without the use of a checklist in simulation. It was hypothesized that the use of a checklist would reduce the number of omissions.DesignHigh-fidelity simulation study.SettingUniversity-affiliated tertiary care facility.ParticipantsSeven cardiac anesthesiologists created a checklist using a modified Delphi process. Ten residents participated in 4 scenarios separating from CPB in simulation.InterventionsEach scenario was performed first without a checklist and then again with a checklist. An observer graded participants' performance.Measurements And Main ResultsA pre-separation checklist containing 9 tasks was created using the Delphi process. Without using this checklist, 4 tasks were completed in at least 75% of scenarios, and 8 tasks were completed at least 75% of the time when using the checklist. There was a significant improvement in completion of 5 of the 9 items (p< 0.01).ConclusionsA modified Delphi process can be used to create a checklist of steps in preparing to separate from CPB. Using this checklist during simulation resulted in increased frequency of completing designated tasks in comparison to relying on memory alone. Checklists may reduce omission errors during complex periods of anesthesiologists' perioperative workflow.Copyright © 2014 Elsevier Inc. All rights reserved.

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