Features  |   May 2014
Cognitive Aids: Trending, Transformative or Just Too Much?
Author Affiliations
  • Marjorie P. Stiegler, M.D.
    Committee on Patient Safety and Education
Article Information
Airway Management / Cardiovascular Anesthesia / Critical Care / Education / CPD / Patient Safety / Pediatric Anesthesia / Quality Improvement / Features
Features   |   May 2014
Cognitive Aids: Trending, Transformative or Just Too Much?
ASA Monitor 05 2014, Vol.78, 16-18.
ASA Monitor 05 2014, Vol.78, 16-18.
Are cognitive aids just the latest trend, or will their widespread integration truly transform the level of safe patient care we deliver? In the past decade, there has been an enormous increase in use of cognitive aids in anesthesiology, particularly for perioperative emergency situations.1  While this idea is gaining in recent popularity, checklists in the O.R. date back at least to 1924, when Dr. Babcock asked, “Have you a plan of action so developed so that the right thing is always done … and time is not frittered away?” and suggested that “a fixed emergency routine” be “posted on the walls of every operating room and drilled into every member of the staff.”2  This now-landmark manuscript is referenced in many modern discussions of emergency cognitive aids. Nearly a century later, robust development of such aids as well as iterative testing and implementation strategies of such aids are being widely disseminated in top journals. In a recent editorial, Dr. Augoustides and colleagues raised important questions: What is the ideal therapeutic dose of cognitive aids in perioperative practice? Is there a risk of “checklist toxicity” (checklist apathy with deleterious consequences) if this dose is exceeded?3  This article will describe some of the currently available cognitive aids, summarize published implementation strategies and lessons learned, and discuss the potential downsides of checklist toxicity as well as overreliance or misuse of cognitive aids.
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