Effective Surgical Safety Checklist Implementation

Conley, Dante M.; Singer, Sara J.; Edmondson, Lizabeth; Berry, William R.; Gawande, Atul A.

doi:10.1016/j.jamcollsurg.2011.01.052

Cited by 325 publications

(333 citation statements)

References 10 publications

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“…21,22 Awareness of the SSC is integral in its successful adoption; however, it is not sufficient to stop there; it is important to explain the rationale for using the SSC as well as outlining the anticipated benefits. 23 An explicit implementation strategy had been carried out in Calgary, including formal presentation at clinical rounds and web-based resources, which likely contributed to widespread awareness. A large driver of implementation was the introduction of its use via the nursing staff, who were less autonomous in their scope of practice and were mandated by their clinical managers to use the SSC.…”

Section: Discussionmentioning

confidence: 99%

Attitudes and beliefs about the surgical safety checklist: Just another tick box?

Dharampal

Cameron

Dixon

et al. 2016

cjs

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Background: Following a landmark study showing decreased morbidity and mortality after implementation of the surgical safety checklist (SSC), it has been widely adopted into perioperative policy. We explored the impact of attitudes and beliefs surrounding the SSC on its uptake in Calgary. Methods:We used qualitative methodology to examine factors influencing SSC use. We performed semistructured interviews based on Rogers' theory of diffusion of innovation. Purposive and snowball sampling were used to identify surgeons, anesthesiologists and operating room nurses from hospitals in Calgary. Data collection and analysis were based on grounded theory. Two individuals jointly analyzed data and achieved consensus on emerging themes.Results: Generated themes included 1) the SSC has brought organization to previous informal perioperative checks, 2) the SSC is most helpful when it is simple, and 3) the 3 current components of the checklist are redundant. The briefing was considered the most important aspect and the debriefing the least important. Initially the SSC was difficult to implement owing to a shift in time management and perioperative culture; however, it has now assimilated into perioperative routine. Finally, though most participants agreed that the SSC might avoid some delays and complications, only a few believe there have been observable improvements to morbidity and mortality. Conclusion:Although the SSC has been integrated into perioperative practice in Calgary, participants believe that previous informal checkpoints were able to circumvent most perioperative issues. Although the SSC may help with flow and equipment, participants believe it fails to show a subjective, clinically important improvement.Contexte : Après une étude charnière ayant montré une baisse de la morbidité et de la mortalité après la mise en oeuvre de la liste de contrôle de la sécurité chirurgicale, cette dernière a été largement intégrée aux politiques périopératoires. Nous avons examiné l'effet des attitudes et des croyances entourant la liste sur son adoption à Calgary.Méthodes : À l'aide d'une méthode qualitative, nous nous sommes penchés sur les facteurs influençant l'utilisation de la liste. Pour ce faire, nous avons effectué des entrevues semi-dirigées fondées sur la théorie de la diffusion de l'innovation de Rogers. Nous avons utilisé l'échantillonnage dirigé et le sondage en boule de neige pour cibler des chirurgiens, des anesthésiologistes et des membres du personnel infirmier de salle d'opération des hôpitaux de Calgary. La collecte et l'analyse des données étaient fondées sur la théorie ancrée. Deux personnes ont analysé ensemble les données et se sont entendues sur les thèmes émergents.Résultats : Voici les principales conclusions dégagées : 1) la liste a permis de structurer les contrôles périopératoires non officiels du passé, 2) la liste est surtout utile quand elle est simple et 3) les 3 composantes actuelles de la liste de contrôle sont redondantes. Le breffage était considéré comme étant l'aspect le plus important e...

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Section: Discussionmentioning

confidence: 99%

Attitudes and beliefs about the surgical safety checklist: Just another tick box?

Dharampal

Cameron

Dixon

et al. 2016

cjs

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“…Carney et al 22 sugere que as percepções individuais entre os membros da equipe cirúrgica sobre a importância de cada item do checklist influenciam diretamente na sua implementação. Segundo Conley et al 23 , um novo instrumento não deve apenas ser implantado; deve-se explicar para a equipe, no momento da implantação, por que e como ele deve ser utilizado.…”

Section: Discussionunclassified

Avaliação da adesão ao checklist de cirurgia segura da OMS em cirurgias urológicas e ginecológicas, em dois hospitais de ensino de Natal, Rio Grande do Norte, Brasil

et al. 2014

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O checklist de cirurgia segura da Organização Mundial da Saúde é uma ferramenta útil para diminuir eventos adversos em hospitais, porém sua implantação efetiva ainda é um desafio. Este estudo objetiva avaliar a adesão ao checklist em cirurgias urológicas e ginecológicas de dois hospitais de ensino em Natal, Rio Grande do Norte, Brasil. O desenho foi observacional transversal; selecionaram-se cirurgias eletivas, e a coleta se deu por meio de revisão de prontuários. Descreveu-se a adesão mediante a existência e qualidade do preenchimento do checklist, e analisou-se a associação de fatores estruturais e socioprofissionais valendo-se de análise de regressão múltipla. Das 375 cirurgias revisadas, 61% tinham checklist, e 4% estavam totalmente preenchidos. A existência do checklist se associou às cirurgias ginecológicas (maternidade) (OR = 130,18) e à maior duração da cirurgia (OR = 2,13), enquanto a qualidade do preenchimento se relacionou com as cirurgias urológicas (hospital geral) (β = 26,36). A adesão ao checklist precisa ser aprimorada, e as diferenças sugerem a influência das distintas estratégias de implantação utilizadas em cada instituição.

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“…An additional 3 studies were deemed to be outside the scope to this review as they assessed nonspecific parameters and irrelevant outcomes. [15][16][17] Consequently, 26 studies were deemed suitable for this systematic review. To provide a better insight into SSC implementation, articles were separated into 2 subsections.…”

Section: Overall Resultsmentioning

confidence: 99%

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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Effective Surgical Safety Checklist Implementation

Cited by 325 publications

References 10 publications

Attitudes and beliefs about the surgical safety checklist: Just another tick box?

Attitudes and beliefs about the surgical safety checklist: Just another tick box?

Avaliação da adesão ao checklist de cirurgia segura da OMS em cirurgias urológicas e ginecológicas, em dois hospitais de ensino de Natal, Rio Grande do Norte, Brasil

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

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