Checklists and Decision Support in Primary Care

Kenneth Lin

First published 5/26/11 on Common Sense Family Doctor

Last year, I wrote a blog post on the potential role of checklists, if any, in primary care medicine. Although checklists have recently led to impressive improvements in patient safety in the fields of surgery and critical care, I had doubts that they could be applied to the broader specialties of family medicine, general internal medicine, and general pediatrics:

Primary care is, by nature, inherently less predictable than surgery or construction or piloting a commercial airliner. Beyond patients scheduled for health maintenance visits or chronic care checkups, we are trained to expect the unexpected, never knowing who is going to walk into the door on any given day with a limp, fracture, shortness of breath, chest pain, or other undifferentiated symptom, each with its own particular diagnostic approach. How can we possibly design a checklist for these? Does it even make sense to do so?

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