I read the article, but I don't see if/where there is responsibility given for the checklist(s). Most QA systems have a source of responsibility and multiple l

I read the article, but I don't see if/where there is responsibility given for the checklist(s). Most QA systems have a source of responsibility and multiple levels of review. I wonder what would happen if there was a QA team (with sufficient education) at a hospital that had complete control over checklists and associated procedures. Would that improve the outcome when utilizing checklists? --- Anecdote --- I've been in the hospital many times, and I've been present for pre-surgical checklists a few times. It was ALWAYS a nurse handling it, and it was never a nurse that I was familiar with during my care. All but once the interactions started with trying to figure out who I was... without asking me. I can recall a number of times where there was a question, such as "Which body part is being operated on?", except I was told the answer. The "question" turned into "Looks like your right kidney is being removed", with a slight pause for me to object. It always made me feel like the staff thought the purpose of the checklist was to complete the checklist, rather than to QA the system they're part of. --- Anecdote Extended --- I suffered an unpleasant complication from this during a procedure. I do not respond to anesthetics the same way as most people. It takes a MUCH larger dose to knock me out, and to keep me out. (years of desensitizing medications + big (very tall) person + MC1R gene). I know this. I can communicate my past procedures and the doses administered. USUALLY they are supposed to ask if you've had any prior procedures and potentially follow up with questions about allergies, anesthetics and other questions related to sedation. I was not asked. I didn't think to speak up because I was already being inundated with stimulus. The result? The first "count down from 10" resulted in me counting to 0 and asking "What next?". I vividly remember the abject horror on the face of the nurse. She fumbled around, whispered to the anesthesiologist, whispered to other nurses. People shuffled around and nobody said a word to me. I was scared. It felt like forever before I was asked to count down from 10 again. It worked that time... Until I woke up in the middle of the procedure! When I woke up in post-op, I asked the nurse about it and she told me that I wouldn't remember any of it. She told my wife that I wouldn't remember the couple hours after post-op. I remember every single nurse's and doctor's name involved and the discussions my wife had with the doctor in post-op (which she confirms my recollection). It could have all be avoided if someone just said, "Hey, have you had a procedure where you've been under general anesthesia before?" I bet that checkbox was ticked though.