Implementing Checklists in your Medical Practice


Harvard surgeon Atul Gawande, MD recently did a TED Talk titled How do we Heal Medicine. Dr. Gawande spoke about the cost and outcomes that are involved within medicine. Gawande focused on the structure of medicine and how it has been built around the concept of independence, self-sufficiency, and autonomy. He believes medicine should be more focused around a team structure, which Gawande refers to as a pit crew versus being a cowboy.

A pit crew is always working together. In a medical practice, the doctors, nurses, coders, bookkeepers, billers, and front desk staff, are all part of the same structure and hence the same pit crew. It is critical to know who is responsible for what task within the structure of the organization. If the doctor doesn't complete her notes, the coder can't code her services, then the biller can't bill for them. Certainly some areas may be obvious, but Gawande stressed the importance of using checklists to assist with delegating tasks for each member of the pit crew.

Implementing Checklists

Dr. Gawande implemented his theory by using checklists with a surgical team. The checklist had 19 items on it that were to be performed before a patient even had a knife cut, anesthesia or leaves their room for surgery. The point was to identify any possible dangers before surgery to decrease the number of complications or deaths during surgery. As a result, they found that this implementation reduced complications by 35% and death by 47%. It forced those involved to look at things like humility, discipline and team work. It challenged the structure of independence, self-sufficiency and autonomy that medicine had been built around.

The idea of implementing checklists isn't just a relevant tool for the medical field but for any industry. However, Gawande explains that implementation has been slow. Why? It comes down to that idea of independence and autonomy, where the individual has the belief they know exactly what needs to be done in their job even if mistakes are still happening.

How The Billing Department Implemented Checklists

Here at The Billing Department, we have been working with checklists for several years. Each day, week and month, we have specific tasks that need to be completed. Checklist are critical for keeping the team on track. Our checklists breakdown exactly what needs to be done and prevents mistakes from happening. Each member of the team is accountable for their individual work and the checklist allows them to stay up to date and help the team achieve the same goals.