Implementation and evaluation of a checklist to improve patient care on surgical ward rounds

Pitcher, Meron; Lin, Joshua T. W.; Thompson, Graeme; Tayaran, Ammar; Chan, Steven

doi:10.1111/ans.13151

Cited by 21 publications

(23 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…a separate checklist to ensure that certain tasks had been addressed. In 2016, Pitcher et al 10 reported a similar study with the same 2-week audit period. Introduction of a checklist for general surgical ward rounds similar to that of the current study occurred after this period.…”

Section: Discussionmentioning

confidence: 94%

Using a Structured Checklist to Improve the Orthopedic Ward Round: A Prospective Cohort Study

Talia¹,

Drummond²,

Muirhead³

et al. 2017

Orthopedics

View full text Add to dashboard Cite

Comprehensive and timely documentation on orthopedic ward rounds continues to be problematic, leading to delayed or inappropriate patient care and miscommunication between health care providers. The authors introduced a simple checklist to improve the documentation on orthopedic ward rounds in their institution. A prospective cohort study was performed. Standard care was provided for cohort A. During a 2-week period, the documentation of patient care by physicians following a ward round was assessed in terms of venous thromboembolism prophylaxis, fasting status, wound or dressing plan, weight-bearing status, and important surgical details. The physicians were blinded to this initial review. For cohort B, a structured ward round checklist was introduced during a 2-week period. A total of 132 patient encounters were recorded in cohort A. Important issues that were rarely discussed included vital signs (11.4%), venous thromboembolism prophylaxis (9.8%), and bowel status (3.8%). Issues that were poorly documented included fasting status (9.1%), wound or dressing plan (6.8%), and weight-bearing status (11.4%). After introduction of the checklist, daily documentation of surgical details improved from 38.6% to 85.3% of patient encounters. Fasting status documentation improved from 9.1% to 70.6% of patient encounters. Venous thromboembolism prophylaxis discussion increased from 9.8% to 45.6% of the time, while its documentation improved from 6.8% to 92.6%. Documentation of weight-bearing status improved from 11.4% to 83.8% (all P<.0001). The use of a structured checklist during orthopedic ward rounds led to significant improvement in both the consideration and the documentation of key aspects of surgical care. [Orthopedics. 2017; 40(4):e663-e667.].

show abstract

Section: Discussionmentioning

confidence: 94%

Using a Structured Checklist to Improve the Orthopedic Ward Round: A Prospective Cohort Study

Talia¹,

Drummond²,

Muirhead³

et al. 2017

Orthopedics

View full text Add to dashboard Cite

show abstract

“…Key ingredients in surgical checklists include: patient details, members of the multidisciplinary team, bedside patient consultation, history and examination findings, review of drains/tubes/lines, charts and medical investigations, documentation, estimated discharge date and presence of relatives/relevant discussions (Fig. 5 ) [ 68 , 69 ]. Indeed with advances in electronic patient records, surgical ward round templates can be introduced to ensure standardization and optimization of patient care—variations of these proformas can then be adjusted to suit the specifics in each specialty.…”

Section: Resultsmentioning

confidence: 99%

“The Longest Way Round Is The Shortest Way Home”: An Overhaul of Surgical Ward Rounds

et al. 2017

View full text Add to dashboard Cite

BackgroundWard rounds, a keystone of hospital surgical practice, have recently been under the spotlight. Poor-quality ward rounds can lead to a greater number of adverse events, thereby cascading to an increased financial strain on our already burdened healthcare systems. Faced with mounting pressures from both outside and inside health organizations, concerted efforts are required to restore it back into prominence where it can no longer take a backseat to the other duties of a surgeon.MethodsThe nucleus of this narrative review is derived from an extensive literature search on surgical ward rounds.ResultsIn this review, we focus on the need for reforms, current characteristics of surgical ward rounds, obstacles encountered by competing interests and proposed solutions in delivery of effective ward rounds that can meet with newly laid guidelines.ConclusionWard rounds should be standardized and prioritized to improve patient care.

show abstract

“…More recently, these tools have been embraced by the medical community to improve patient safety and patient care 5–7 12–14. The evidence supporting checklist utilisation has also grown with numerous examples of their positive influence on patient safety and outcomes in a variety of clinical settings 5 10 15–24. For example, in several high-risk work environments such as the intensive care unit,25–27labour and delivery,18 28 emergency centre,16 operating room8 10 11 29–40 and radiology,21 41 checklists have clearly demonstrated positive results for facilitating complex multistep processes leading to error reduction.…”

Section: Literature Reviewmentioning

confidence: 99%

Checklist design and implementation: critical considerations to improve patient safety for low-frequency, high-risk patient events

et al. 2019

View full text Add to dashboard Cite

Purpose: This pilot project describes the development and implementation of two specialised aviation-style checklist designs for a low-frequency high-risk patient population in a cardiac intensive care unit. The effect of the checklist design as well as the implementation strategies on patient outcomes and adherence to best practice guidelines were also explored. The long-term objective was to improve adherence to accepted processes of care by establishing the checklists as standard practice thereby improving patient safety and outcomes.Methods: During this project, 10specialised crisis checklists using two specific aviation-style designs were developed. A quasiexperimental prospective pre-post repeated measure design including surveys along with repetitive simulations were used to evaluate self-confidence and self-efficacy over time as well as the perceived utility, ease of use, fit into workflow and benefits of the checklists use to patients. Performance, patient outcomes and manikin outcomes were also used to evaluate the effectiveness of the crisis checklists on provider behaviours and patient outcomes.Results: Overall self-confidence and self-confidence related to skills and knowledge while not significant demonstrated clinically relevant improvements that were sustained over time. Perceptions of the checklists were positive with consistent utilisation sustained over time. More importantly, use of the checklists demonstrated a reduction in errors both in the simulated and clinical setting.Conclusion: Recommendations from this study consist of key considerations for development and implementation of checklists including: utilisation of stakeholders in the development phase; implementation in real and simulated environments; and ongoing reinforcement and training to sustain use.

show abstract

Implementation and evaluation of a checklist to improve patient care on surgical ward rounds

Abstract: The use of a checklist during surgical ward rounds makes significant improvement in the consideration of most key aspects of care and education in the completion of a structured progress form substantially improved documentation.

Cited by 21 publications

References 10 publications

Using a Structured Checklist to Improve the Orthopedic Ward Round: A Prospective Cohort Study

Using a Structured Checklist to Improve the Orthopedic Ward Round: A Prospective Cohort Study

“The Longest Way Round Is The Shortest Way Home”: An Overhaul of Surgical Ward Rounds

Checklist design and implementation: critical considerations to improve patient safety for low-frequency, high-risk patient events

Contact Info

Product

Resources

About