Systematic review of safety checklists for use by medical care teams in acute hospital settings—limited evidence of effectiveness.

Checklists have resulted in some of the most prominent successes of the patient safety movement, and the resulting publicity has led to wider implementation of checklists in a variety of care settings. This rapid dissemination of checklists has been accompanied by cautionary notes from those who have examined successful checklist-based interventions, who stress the importance of safety culture and other factors in ensuring intervention success. This systematic review of nine published studies of checklists also strikes a cautionary note, finding only moderate evidence that checklists are associated with safety improvements and noting significant methodological weaknesses in the existing literature base. Checklists are a powerful improvement tool, but as this study highlights, their success is often dependent on other interventions.