I suspect a lot of this would be more difficult now. I had minor surgery not long ago and (while I was still conscious) everyone in the room (including me) had to agree what was about to happen, sound off about their part in it, and confirm that they had everything they needed for their part, before continuing.
It did make me feel more comfortable about he process.
There's a fair bit of evidence that -- regardless of how they might seem at first -- these types of "checklist" procedures really do reduce error rates. Much of it is cross-pollination from aviation safety, where use of checklists has been standard procedure for a long time.
This New Yorker article talks a bit about the early days of aviation checklists, and some attempts to apply them in medicine, including a hospital which tried checklists as a method of avoiding common causes of line infections with IVs. The result:
These steps are no-brainers; they have been known and taught for years. So it seemed silly to make a checklist just for them. Still, Pronovost asked the nurses in his I.C.U. to observe the doctors for a month as they put lines into patients, and record how often they completed each step. In more than a third of patients, they skipped at least one.
The next month, he and his team persuaded the hospital administration to authorize nurses to stop doctors if they saw them skipping a step on the checklist; nurses were also to ask them each day whether any lines ought to be removed, so as not to leave them in longer than necessary. This was revolutionary. Nurses have always had their ways of nudging a doctor into doing the right thing, ranging from the gentle reminder (“Um, did you forget to put on your mask, doctor?”) to more forceful methods (I’ve had a nurse bodycheck me when she thought I hadn’t put enough drapes on a patient). But many nurses aren’t sure whether this is their place, or whether a given step is worth a confrontation. (Does it really matter whether a patient’s legs are draped for a line going into the chest?) The new rule made it clear: if doctors didn’t follow every step on the checklist, the nurses would have backup from the administration to intervene.
Pronovost and his colleagues monitored what happened for a year afterward. The results were so dramatic that they weren’t sure whether to believe them: the ten-day line-infection rate went from eleven per cent to zero. So they followed patients for fifteen more months. Only two line infections occurred during the entire period. They calculated that, in this one hospital, the checklist had prevented forty-three infections and eight deaths, and saved two million dollars in costs.
It did make me feel more comfortable about he process.