Effect of the surgical safety checklist on provider and patient outcomes: a systematic review

Armstrong, Bonnie; Dutescu, Ilinca A.; Nemoy, Lori; Bhavsar, Ekta; Carter, Diana N; Ng, Kimberley-Dale; Boet, Sylvain; Trbovich, Patricia; Palter, Vanessa N.

doi:10.1136/bmjqs-2021-014361

Cited by 12 publications

(12 citation statements)

References 37 publications

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Section: Discussionmentioning

confidence: 99%

“…Research on the WHO SSC has made great strides in the last decade and its evidence cannot be denied ( 2 ). Nevertheless, the exact mechanisms of the advantage and application of the checklist are still not fully understood ( 2 ). As this review shows, some of these mechanisms were recognized at the level of team behavior and process implementation through qualitative studies.…”

Section: Discussionmentioning

confidence: 99%

“…The positive effects of the WHO SSC on postoperative patient outcomes, such as decreased complication and mortality rate, has been demonstrated in multiple studies, although the study results sometimes differ vastly in the endpoints chosen, the study design, the population size and the content ( 2 - 8 ). The WHO SSC was also found to have a positive overall effect on the workflow in the operating room (OR) and the perceptions of OR staff ( 9 , 10 ).…”

Section: Introductionmentioning

confidence: 99%

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Make a difference: implementation, quality and effectiveness of the WHO Surgical Safety Checklist—a narrative review

Wyss,

Kolbe,

Grande

2023

J Thorac Dis

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Background and Objective The positive effects of the WHO Surgery Safety Checklist (WHO SSC) have been demonstrated by a large amount of quantitative studies. With this review, the focus changes to the content of qualitative studies on WHO SSC to identify possible research gaps. In this way, gaps in the content of the execution of individual checklists can be closed. Methods The two research platforms “Ovid Medline” and “PubMed” formed a solid basis for the literature research. The search was conducted until the 19 th of September 2022. The following group terms were used: “checklist”, “surgery”, “implementation”, and “WHO Surgical Safety Checklist”. Subsequently, the literature research was limited to studies between 2011 and 2021 in either English or German. Key Content and Findings Overall, a positive effect was found in all qualitative studies on WHO SSC with respect to leadership, teamwork, timing and acceptance. Acceptance through effective implementation of the SSC deserves special mention. Several studies highlighted the lack of understanding and training, which led to variation in execution. A large number of studies agree that the WHO SSC is fostering teamwork and improving communication. However, there are also hurdles and barriers in the application that seem to have an influence on the effectiveness. Conclusions The exact mechanisms of the advantage and application of the checklist are still poorly understood. Further research in this area is needed for a better understanding of the underlying work culture and consequently improving patient safety.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Make a difference: implementation, quality and effectiveness of the WHO Surgical Safety Checklist—a narrative review

Wyss,

Kolbe,

Grande

2023

J Thorac Dis

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“…Though many components of checklists in high-risk industries are obvious and familiar, the routine use of them ensures a reproducible approach across all users and could prevent easily avoided disasters (Ely et al, 2011). Surgical safety checklists are one example of how the healthcare sector has successfully adopted widespread use of checklist-based interventions to reduce human errors (Armstrong et al, 2022). In medical diagnosis, different checklists can be used in different steps of diagnosis.…”

Section: Characterizing Identified Debiasing Interventionsmentioning

confidence: 99%

Debiasing and Educational Interventions in Medical Diagnosis: A Systematic Review

Tung

Melchiorre

2022

Preprint

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Background: The prevalence of cognitive bias and its contribution to diagnostic errors has been documented in recent research. Debiasing interventions or educational initiatives are key in reducing the effects and prevalence of cognitive biases, contributing to the prevention of diagnostic errors. The objectives of this review were to 1) characterize common debiasing strategies implemented to reduce diagnosis-related cognitive biases, 2) report the cognitive biases targeted, and 3) determine the effectiveness of these interventions on diagnostic accuracy. Methods: Searches were conducted on April 25, 2022, in MEDLINE, EMBASE, Healthstar, and PsycInfo. Studies were included if they presented a debiasing intervention that aimed to improve diagnostic accuracy. The Rayyan review software was used for screening. Quality assessments were conducted using the JBI Critical Appraisal Tools. Extraction, quality assessment and analysis were recorded in Excel. Results: Searches resulted in 2232 studies. 17 studies were included in the final analysis. Three major debiasing interventions were identified: tool use, education of biases, and education of debiasing strategies. All intervention types reported mixed results. Common biases targeted include confirmation, availability, and search satisfying bias. Conclusion: While all three major debiasing interventions identified demonstrate some effectiveness in improving diagnostic accuracy, included studies reported mixed results when implemented. Furthermore, no studies examined decision-making in a clinical setting, and no studies reported long-term follow-up. Future research should look to identify why some interventions demonstrate low effectiveness, the conditions which enable high effectiveness, and effectiveness in environments beyond vignettes and among attending physicians.

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“…1,7 To achieve such results, it is essential the CL must be well-known and accepted by professionals working in the OR. [8][9][10][11][12][13][14][15][16][17][18] In the context a total quality management program aiming at continually improving the quality of care, the CL was initially implemented in the neurosurgery OR at Sahloul Teaching Hospital of Tunisia, since 2019. [19][20][21][22][23][24] After this initial implementation, the generalization of the use of the CL was targeted through the training of all the hospital's OR staff.…”

Section: Introductionmentioning

confidence: 99%

Perceptions and use of surgical checklist practices in a tertiary hospital of Tunisia, 2023

Bhiri,

Ben Amor,

Bouhlel

et al. 2023

JACCOA

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Introduction: Patient safety remains a major concern in the operating room (OR). The surgical checklist (CL) is presented as a solution for reducing postoperative complications by ensuring better patient safety, but the adoption and use of this tool remain modest in our ORs. So, we aimed to describe CL use practices and perceptions among OR professionals at the University Hospital Center (UHC) of Sahloul, Sousse in 2023. Methods: This was a cross-sectional study among OR professionals at UHC of Sahloul. Data were collected using a questionnaire and an observation grid. Results: The average age of respondents was 38.05 (±8 years) with a female predominance. Our results revealed positive perceptions (98.7%) regarding the usefulness of the surgical CL. Some difficulties were raised by participants, notably the difficulty of accepting verbalization aloud (59.4%), the anxiety generated by multiple checks for the patient (58.8%) and the difficulty of implementing CL during emergency interventions (49.4%). The observation grid revealed the rate of CL use in the OR (70.8%) and inadequate practices in the quality of CL item completion: Variation in the quality of CL item completion from one stage to the next; Items mostly ticked without verification, with only the patient identification (69.1%), procedure site (64.7%), known allergy (47.1%) and antibiotic prophylaxis (61.8%) items being checked aloud. Conclusion: CLs in the operating room are essential to guarantee safe, quality care. It is therefore essential that healthcare professionals, healthcare establishments and decision-makers not only recognize its importance, but also implement the necessary measures for its adoption and systematic use.

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Effect of the surgical safety checklist on provider and patient outcomes: a systematic review

Cited by 12 publications

References 37 publications

Make a difference: implementation, quality and effectiveness of the WHO Surgical Safety Checklist—a narrative review

Make a difference: implementation, quality and effectiveness of the WHO Surgical Safety Checklist—a narrative review

Debiasing and Educational Interventions in Medical Diagnosis: A Systematic Review

Perceptions and use of surgical checklist practices in a tertiary hospital of Tunisia, 2023

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