Intelligent dynamic clinical checklists improved checklist compliance in the intensive care unit

Background: Checklists can reduce medical errors. However, the use of checklists is hampered by lack of acceptance and compliance. Recently, a new kind of checklist with dynamic properties has been created to provide more specific checklist items of a patient to the specific caregiver. Our purpose of this simulation based study was to investigate the first developed intelligent dynamic clinical checklist (DCC) for the Intensive Care Unit (ICU) ward round. METHODS: Eligible clinicians were invited to participate as volunteers. Highest achievable scores were established for six typical ICU scenarios to determine which items must be checked. The participants compared the DCC with the local standard of care. The primary outcomes were the caregiver satisfaction score and, the percentages of checked items overall and of critical items requiring a direct intervention. RESULTS: In total twenty participants were included, who performed 116 scenarios. The median percentage of checked items was 100.0% with the DCC, compared to 73.6% for the scenarios completed with local standard of care (p<0.001). In the scenarios performed with local standard of care remained 23.1% of the critical items unchecked, in contrast to 0.0% if the DCC was available (p<0.001). The mean satisfaction score of the DCC was 4.13 out of 5. CONCLUSION: This simulation study indicates that an intelligent DCC significantly increases compliance to best practice by reducing the percentage of unchecked items during ICU ward rounds, while the user satisfaction rate remains high. More, real life, clinical research is required to further evaluate this new kind of checklist