Improvement in staff compliance with a safety standard checklist in endoscopy in a tertiary centre

Abstract

National Health Service England published the National Safety Standards for Invasive Procedures (NatSSIP) in 2015. They mandated that individual trusts produce Local Safety Standards for Invasive Procedures (LocSSIPs), a set of safety standards drawn from the NatSSIP that apply to a particular clinical situation in a given department, for all invasive procedures.The project goal was to design and implement the LocSSIP within the endoscopy department. A draft LocSSIP was produced, and a pilot study conducted to gain initial feedback on its use. Version 1 of the checklist was produced and after approval, rolled out for use within the endoscopy department at ‘time out’ and ‘sign out’. A scoring system was developed that allowed the quality of the performance of LocSSIPs to be assessed and recorded as a ‘compliance score’.After 2 months, an independent observer spent a week assessing use of the checklist, recording completion and a compliance score. Analysis of this data led to a number of changes in performing the checklist, wider multidisciplinary team education and integration of the checklist into existing documentation, before reassessing at 12 months.In 2016, ‘time out’ checks were completed in 100% of cases, but full completion was only observed in 68%. ‘Sign out’ checks were completed in 91% of cases, with full completion in 71%. In 2017, ‘time out’ checks were completed in 100% of cases, with full completion in 85%. ‘Sign out’ checks were completed in 100% of cases, with full completion in 91%.The composite score for compliance in 2016 was 57% increasing to 90% in 2017.In conclusion, stronger departmental leadership, broadening education and integration of the checklist into routine documentation to reduce duplication led to significant improvements in compliance with use of the checklist. Ongoing education and assessment is imperative to ensure that compliance is maintained to ensure patient safety.

Implementation of a Customized Safety Checklist in Gastrointestinal Endoscopy and the Importance of Team Time Out—A Dual-Center Pilot Study

“…In many places, the endoscopy has developed in the ad hoc way, following a variety of business models. Although an endoscopy team is a little unusual compared to other diagnostic health services, the team members still need to work in a coordinated and organized way, they must be trained to do their jobs, be motivated to excel, know what is expected from them and know their responsibilities [ 16 ].…”

Posicionamiento científico de la Asociación Mexicana de Endoscopia Gastrointestinal en procedimientos anestésicos en endoscopia

“…Existen listas con diversos contenidos y sugerimos que esta contenga: identidad del paciente mediante doble verificador (p. ej., nombre y fecha nacimiento, edad), presentación de cada integrante del equipo de endoscopia, indicación del estudio, firma de los consentimientos informados, uso de prótesis dentales, comorbilidades importantes, alergias, uso de antitrombóticos, correcto funcionamiento del equipo y monitorización adecuada 43,44 (Tabla 4).…”

Improving Clinical Documentation Compliance Pre-Gastrointestinal Endoscopy Procedures Through the Use of an Endoscopy Checklist

“…These tools have enhanced provider-to-provider communication by empowering team members to speak up with questions and concerns before the procedure (Wright, 2016). Checklists are a well-established and simple standardized tools for clinicians to point out discrepancies that can lead to patient harm, yet there is a paucity of their use in gastroenterology endoscopy units (Mason et al, 2018).Structured communication patterns enable clinicians to stay focused and avoid distractions that may lead to patient risk. According to the Agency for Research and Health Care Quality (Agency for Healthcare Research and Quality Patient Safety Network, 2019), most errors in healthcare occur as a result of "slips."…”

“…These tools have enhanced provider-to-provider communication by empowering team members to speak up with questions and concerns before the procedure (Wright, 2016). Checklists are a well-established and simple standardized tools for clinicians to point out discrepancies that can lead to patient harm, yet there is a paucity of their use in gastroenterology endoscopy units (Mason et al, 2018).…”