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Cited by 75Electronic Health Records SystemsPatient Safety and Medication ErrorsClinical Reasoning and Diagnostic Skills

Checking the Lists: A Systematic Review of Electronic Checklist Use in Health Care

Open access
Kramer, Heidi S., Drews, Frank A.·2017·Journal of Biomedical Informatics
DOI 10.1016/j.jbi.2016.09.006
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Abstract

Objective We conducted a literature search to examine the effects and experiences surrounding the transition from paper to electronic checklists in healthcare settings. We explore the types of electronic checklists being used in health care, how and where they were evaluated and seek to identify the successes and failures of using electronic checklists in healthcare, including use of checklists to ensure completeness of documentation in the electronic medical record. Background Formalized checklist use as a memory and decision aid in aviation has resulted in significant increases in safety in that domain. Checklists have also been successfully introduced to reduce errors in some areas of healthcare; however, in some contexts checklists failed to provide some of the expected benefits. Adapting and integrating checklists electronically into the healthcare workflow provides opportunities and challenges that need to be better understood to make checklist adoption a success in health care. Method We conducted a literature search of the English language literature in MEDLINE using PubMed for peer-reviewed literature of implementation and use of electronic or computerized checklists related to clinical or healthcare use. We reviewed the studies and included in this review those papers that discussed in depth the development process and that conducted controlled studies to assess the effectiveness of checklists and the evaluation of their acceptance in the clinical context. Results The literature search using the keywords electronic checklist OR computerized checklist returned a total of 23 peer-reviewed papers. Out of these 15 were included in the review, with 8 excluded because they did not evaluate checklist use for patient care. Application More rigorous application of known principles and methods from Human Computer Interaction research and the behavioral sciences can provide a clearer, more comprehensive understanding of the conditions that affect the development and use of checklists.

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  • Checklists are designed to guide diagnostic reasoning and act as cognitive aids that support clinicians.

    “Checklists are designed to guide diagnostic reasoning and act as cognitive aids that support clinicians.”

    From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [203]

    Section 1.1 describes checklists as decision and memory aids and identifies flowchart/diagnostic checklists that can guide clinical decisions. But it distinguishes those from other checklist types that primarily support memory, so the claim overgeneralizes when it says checklists are designed to guide diagnostic reasoning. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • Checklists encourage analytic thinking instead of relying solely on intuition and memory, prompting clinicians to consciously examine their diagnostic approach.

    “They encourage analytic thinking instead of relying solely on intuition and memory, prompting them to consciously examine their diagnostic approach [202,203].”

    From Toward Safer Diagnoses: A SEIPS-Based Narrative Review of Diagnostic Errors (2026) · cites this paper as [203]

    Section 1.1 describes checklists as decision aids that direct attention to logically important aspects of a problem, reduce cognitive biases, and supplement memory. It also describes diagnostic flowchart checklists with decision points. However, the paper does not establish that checklists generally prompt clinicians to consciously examine their diagnostic approach; the Methods section says the review excludes flowchart-style diagnostic decision support. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

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1 of the 45 references couldn’t be matched to a known paper.

Research works printed but not linked: 1

  1. J. Reason, Human Error, Cambridge University Press, New York, NY, 1990.

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Authors
Kramer, H. S., & Drews, F. A.
Affiliations
University of Utah (US)
Corresponding author
Kramer, Heidi S.
ORCID
Drews, Frank A.
Venue
Journal of Biomedical Informatics
Publisher
Elsevier BV
Published
2017-07
Volume
71
Pages
S6-S12
ISSN
1532-0464 (ISSN-L)
DOI
10.1016/j.jbi.2016.09.006
OpenAlex
W2519750805
Cited by
75
References
45
Citations by year
2026: 4 · 2025: 5 · 2024: 7 · 2023: 14 · 2022: 3 · 2021: 8 · 2020: 13 · 2019: 7 · 2018: 7 · 2017: 7
FWCI
1.43
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Biomedical Informatics (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Health Professions › Health Information Management › Electronic Health Records Systems
  • Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
  • Health Sciences › Medicine › Family Practice › Clinical Reasoning and Diagnostic Skills
Keywords
electronic checklists, print-to-digital transition, electronic health records, healthcare workflow, medical errors, checklist evaluation, human-computer interaction, behavioral science
MeSH terms
Decision Support Techniques, Delivery of Health Care, Humans, Workflow, Checklist

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