Development and validation of patients’ surgical safety checklist

Abstract

Background Poor uptake and understanding of critical perioperative information represent a major safety risk for surgical patients. Implementing a patient-driven surgical safety checklist might enhance the way critical information is given and increase patient involvement in their own safety throughout the surgical pathway. The aim of this study was to develop and validate a Surgical Patient Safety Checklist (PASC) for use by surgical patients. Method This was a prospective study, involving patient representatives, multidisciplinary healthcare professionals and elective surgical patients to develop and validate PASC using consensus-building techniques in two Norwegian hospitals. A set of items intended for PASC were rated by patients and then submitted to Content Validation Index (CVI) analyses. Items of low CVI went through a Healthcare Failure Mode and Effect Analysis (HFMEA) Hazard Scoring process, as well as a consensus process before they were either kept or discarded. Reliability of patients’ PASC ratings was assessed using Intraclass Correlation Coefficient analysis. Lastly, the face validity of PASC was investigated through focus group interviews with postoperative patients. Results Initial development of PASC resulted in a checklist consisting of two parts, one before (32 items) and one after surgery (26 items). After achieving consensus on the PASC content, 215 surgical patients from six surgical wards rated the items for the CVI analysis on a 1-4 scale and mostly agreed on the content. Five items were removed from the checklist, and six items were redesigned to improve PASCs’ user-friendliness. The total Scale-level index/Average (S-CVI/Ave) before revision was 0.83 and 0.86 for pre- and post-operative PASC items, respectively. Following revision, these increased to 0.86 and 0.93, respectively. The PASC items reliability score was 0.97 (95% confidence interval 0.96 to 0.98). The qualitative assessment identified that patients who used PASC felt more in control of their situation; this was achieved when PASC was given to them at what they felt was the right time and healthcare professionals took part in its usage. Conclusion Multidisciplinary perioperative care staff and surgical patients agreed upon PASC content, the checklist ratings were reliable, and qualitative assessment suggested good face validity. PASC appears to be a usable and valid checklist for elective surgical patients across specialties.

Feasibility of implementing a surgical patient safety checklist: prospective cross-sectional evaluation

“…Both parts of PASC are provided to the patients in paper format 2 to 12 weeks before surgery. The content and wording of the PASC items are based on extensive developmental and validation work with patients and healthcare professionals, reported in a previous study [ 10 ]. The overall PASC content was reduced to 27 preoperative items and 20 postoperative items based on the data collection in the aforementioned study.…”

“…The overall PASC content was reduced to 27 preoperative items and 20 postoperative items based on the data collection in the aforementioned study. The full version of the checklist was translated to English and published [ 10 ]. Please see additional file 1 for PASC item questions and for the item response rate.…”

“…More recently, our group developed a novel surgical patient safety checklist (PASC) [ 10 ]. This checklist has been developed over the past 5 years following recommended guidelines for patient checklist design [ 11 ] and with the main aim to increase patients’ involvement in the safety of their own care [ 10 , 12 ].…”

“…More recently, our group developed a novel surgical patient safety checklist (PASC) [ 10 ]. This checklist has been developed over the past 5 years following recommended guidelines for patient checklist design [ 11 ] and with the main aim to increase patients’ involvement in the safety of their own care [ 10 , 12 ]. To date, we have reported on development and content validity of PASC, and we have optimised its usability through a reduction in number of items and clarifications of checklist content [ 10 ].…”

Validación del paciente como auditor de prácticas seguras. Factores facilitadores desde una triple perspectiva: pacientes, profesionales y gestores

“…Comprenden elementos como la medicación previa a la cirugía, la preparación o si precisa ayunas y desde cuándo. Además también incluyen el proceso postoperatorio, la preparación para el alta y la identificación de complicaciones y cómo actuar si se desarrollan [60][61][62] .…”