A pilot study of the implementation of <scp>WHO</scp><scp>S</scp>urgical <scp>C</scp>hecklist in <scp>F</scp>inland: improvements in activities and communication

Takala, Riikka; Pauniaho, Satu‐Liisa; Kotkansalo, Anna; Helmiö, Päivi; Blomgren, Karin; Helminen, Mika; Kinnunen, Marina; Takala, Aino K.; Aaltonen, Riikka; Katila, Ari; Peltomaa, Karolina; Ikonen, Tuija

doi:10.1111/j.1399-6576.2011.02525.x

Cited by 99 publications

(96 citation statements)

References 28 publications

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“…5,[18][19][20][21][22][23] Specifically, use of the WHO SSC has shown a decrease in inpatient morbidity and mortality 2,[4][5][6][7]24 as well as improvement in teamwork skills, communication, and adherence to process measures. 1,23,[25][26][27] Nevertheless, Ko et al's recent systematic review of checklist use in medicine has shown limited evidence of their effectiveness. 28 Analysis of the studies indicated that many were of poor quality with low levels of evidence and a high rate of bias.…”

Section: Discussionmentioning

confidence: 99%

Surgical safety checklist: implementation in an ambulatory surgical facility

Morgan

Cunningham

Mitra

et al. 2013

Can J Anesth/J Can Anesth

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Purpose In 2007, the World Health Organization created a Surgical Safety Checklist (SSC) that encompassed a simple set of surgical safety standards. The threefold purpose of this study was to add ambulatory-specific items to the SSC, to introduce the items into an ambulatory surgical facility, and to determine if patient outcomes regarding postoperative pain and nausea/vomiting improved following implementation. In addition, safety attitudes, antibiotic timing, regional anesthesia/nerve blocks, preemptive pain medications, prophylactic antiemetics, length of stay, and hospital admission were also assessed.Methods After Research Ethics Board approval, staff complete a Safety Attitudes Questionnaire. Seven items were added to the SSC. Data were then collected on 180 surgical cases before SSC implementation and 195 cases following implementation. Compliance with each section of the SSC was assessed. Results On postoperative day one, the median (97.5% confidence interval [CI]) difference between pre-and postimplementation pain scores was 0.5 (97.5% CI, 0 to 1; P = 0.13), and the median difference in the rate of postdischarge nausea/vomiting was -8.4% (97.5% CI, -17.9 to 1.1; P = 0.06). There was no improvement in safety attitudes or any of the secondary outcomes, with the exception of the use of preemptive pain medications. Compliance with the three sections of the checklist, i.e., BRIEFING, TIME OUT, and DEBRIEFING was 99.49%, 97.95%, and 96.92%, respectively. There was low compliance in verbalization of the added ''ambulatory-specific items''. Conclusion Potential reasons for lack of uptake and integration include poor ''user'' buy-in, an overly lengthy checklist, and lack of prioritization of ambulatory-specific items. A shortened SSC was developed based on the results of this study. This trial was registered at ClinicalTrials.gov ID: NCT00934310.Author contributions Pamela J. Morgan was involved in the acquisition of funding for this study. Pamela J. Morgan Lisa Cunningham, Wei Wu, Victoria Noguera, and John Semple were involved in the conception and design of the study. Lisa Cunningham, Sohini Mitra, Natalie Wong, and Mary Li were involved in the acquisition of data for the study. Pamela J. Morgan was involved in the interpretation of the data. Pamela J. Morgan, Wei Wu, and Mary Li analyzed the data. Pamela J. Morgan, Lisa Cunningham, and Mary Li were involved in drafting the article. Sohini Mitra, Natalie Wong, Wei Wu, Victoria Noguera, and John Semple were involved in the critical revision of the article. Résumé Objectif En 2007, l'Organisation mondiale de la Sante´a cre´e´une Liste de contrôle de la se´curite´chirurgicale (LCSC) couvrant un ensemble simple de normes de se´curite´pour la chirurgie. L'objectif triple de cette e´tude e´tait d'ajouter des e´le´ments spe´cifiques au contexte ambulatoire a`la LCSC, d'introduire ces e´le´ments dans un centre de chirurgie ambulatoire, et de de´terminer si les devenirs des patients en matie`re de douleur et de nause´es et vomissements postope´ratoires e´taien...

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Section: Discussionmentioning

confidence: 99%

Surgical safety checklist: implementation in an ambulatory surgical facility

Morgan

Cunningham

Mitra

et al. 2013

Can J Anesth/J Can Anesth

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“…[7] Another study, showing improvement of patient identification and surgical site confirmation, emphasised that better understanding of each team member's role aided in better communication and teamwork. [8] Other studies have shown contradictory results. Urbach et al [9] investigated the effect of surgical safety checklists at 101 hospitals.…”

Section: Researchmentioning

confidence: 99%

An investigation of barriers to the use of the World Health Organization Surgical Safety Checklist in theatres

Verwey

Gopalan

2018

S Afr Med J

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“…Studies used 2 main methodologies to assess team member attitudes: focused interview of a random sample of operating theatre staff (2 studies) 32,33 and a surgical team questionnaire pre-and post-SSC intervention (8 studies). 9,[34][35][36][37][38][39][40] The studies varied in participant size with 37 to 40 participants in focus group studies across the OR disciplines, 32,33 while the surgical team survey questionnaire studies had participant sizes as large as 1748. The surgical questionnaires were based on resources from previous studies or adapted from the surgical attitudes questionnaire (SAQ).…”

Section: Staff Perceptionmentioning

confidence: 99%

“…36 Additionally, of the 5 studies that examined this category, participants in 3 studies suggested that SSC did not substantially improve team member identification. 9,32,35,39 Six studies conducted crosssectional analyses across OR staff disciplines (surgeons, anesthetists, and nurses). 34,35,37,39,40,42 Nurses valued the gains made by SSC introduction far more than other staff members, but also were the most sensitive to the barriers inhibiting its completion, such as poor teamwork.…”

Section: Staff Perceptionmentioning

confidence: 99%

“…9,32,35,39 Six studies conducted crosssectional analyses across OR staff disciplines (surgeons, anesthetists, and nurses). 34,35,37,39,40,42 Nurses valued the gains made by SSC introduction far more than other staff members, but also were the most sensitive to the barriers inhibiting its completion, such as poor teamwork. 40 Anesthetists, on the other hand, were least positively disposed toward checklist completion when compared with surgeons and nurses, 37,40 potentially because it is completed during a period of high workload for anesthetists.…”

Section: Staff Perceptionmentioning

confidence: 99%

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Compliance and Surgical Team Perceptions of WHO Surgical Safety Checklist; Systematic Review

Wangoo

Ray

2016

International Surgery

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This systematic review aimed to assess surgical safety checklist compliance and evaluate surgical team perceptions and attitudes, post-checklist implementation in the operating room. The World Health Organization (WHO) surgical safety checklist (SSC) has decreased complications and mortality. However, it is unclear whether this reduction is influenced by the vicarious enhancement in teamwork, communication, and staff awareness established by SSC implementation. The preferred reporting items for systematic reviews and meta-analyses model of review guided a search across MEDLINE, PubMed, and Embase databases. English-language studies using any adapted form of the WHO-SSC in operating rooms were reviewed by abstract and full text. Twenty-six studies, 13 assessing SSC compliance and 13 investigating surgical team perceptions of SSC, were evaluated. Compliance studies showed a checklist initiation rate of .90%, but actual observed completion rate varied widely across studies. Sign out was the most poorly performed phase of the checklist (,50%) with time out being the best. Verification of patient identity and procedure demonstrated a high degree (.90%) of compliance across studies, but ''verification of team-members'' was significantly less compliant. Studies assessing surgical team perceptions found that SSC improved participants' perception of teamwork, communication, patient safety, and staff awareness of adverse events. However, when stakeholders placed differing degrees of importance on SSC completion, results indicated the SSC might actually antagonize team relationships. SSC compliance varies significantly across studies, being highly dependent on staff perceptions, training, and effective leadership. Surgical teams have positive perceptions

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A pilot study of the implementation of WHOSurgical Checklist in Finland: improvements in activities and communication

Abstract: The checklist increased OR teams' awareness of patient-related issues, the procedure and expected risks. It also enhanced team communication and prevented communication failures. Our findings support use of the WHO checklist in various surgical fields.

Cited by 99 publications

References 28 publications

Surgical safety checklist: implementation in an ambulatory surgical facility

Surgical safety checklist: implementation in an ambulatory surgical facility

An investigation of barriers to the use of the World Health Organization Surgical Safety Checklist in theatres

Compliance and Surgical Team Perceptions of WHO Surgical Safety Checklist; Systematic Review

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