Feasibility of an operational standardized checklist for movement disorder surgery. A pilot study

Abstract

Despite the clinical success of deep brain stimulation (DBS), it remains to be elucidated where within the work process the surgical result could diverge from the surgical plan. We sought to determine this. We implemented a standardized checklist to detect and remediate procedural errors. A consecutive series of 13 patients was studied. Revisions, explantations and thermal lesions were excluded. We tabulated the number and type of errors that could occur when implementing a surgical plan. Errors were categorized as minor or major. The elapsed time was also assessed. A mean of two errors per case were identified: 1.15 major errors/case and 0.85 minor errors per case. The total number of errors identified per case did not change significantly over the course of the series. Time to complete the checklist decreased monotonically from 4 min 5 s to 1 min 10 s. The checklist applied in this scenario is a useful tool to identify and remediate errors during DBS, adding minimal additional operative time and consistently identifying errors.