Patients’ and healthcare workers’ recommendations for a surgical patient safety checklist – a qualitative study

Abstract

Background: Patients' involvement in patient safety has increased in healthcare. Use of checklists may improve patient outcome in surgery, though few have attempted to engage patients' use of surgical checklist. To identify risk elements of complications based on patients' and healthcare workers' experiences is warranted. This study aims to identify what the patients and healthcare workers find to be the risk elements that should be included in a patient-driven surgical patient safety checklist. Method: A qualitative study design where post-operative patients, surgeons, ward physicians, ward nurses, and secretaries from five surgical specialties took part in focus group interviews. Eleven focus groups were conducted including 25 post-operative patients and 27 healthcare workers at one tertiary teaching hospital and one community hospital in Norway. Based on their experiences, participants were asked to identify perceived risks before and after surgery. The interviews were analysed using content analysis.Results: Safety risk factors were categorised as pre-operative information: pre-operative preparations, post-operative information, post-operative plans and follow-up. The subcategories under pre-operative information and preparations were: contact information, medication safety, health status, optimising health, dental status, read information, preparation two weeks before surgery, inform your surgical ward, planning your own discharge, preparation on admission and just before surgery. The subcategories under post-operative information, further plans and follow-up were: prevention and complications, restriction and activity, medication safety, pain relief, stomach functions, further care and appointments. Both healthcare workers and patients express the need for a surgical patient safety checklist. Conclusion:A broad spectre of risk elements for a patient safety checklist were identified. Developing a surgical safety checklist based on these risk elements might reduce complications and unwanted errors. Trail registration: The study is registered as part of a clinical trial in ClinicalTrials.gov: NCT03105713.

A Smartphone App Designed to Empower Patients to Contribute Toward Safer Surgical Care: Qualitative Evaluation of Diverse Public and Patient Perceptions Using Focus Groups

“…For example, some behaviors recommended by the app can be completed privately with very little interaction with health care workers, for example, ensuring nonslip footwear is worn and caring appropriately for surgical wounds following discharge, whereas other behaviors rely heavily on effective communication and may be more strongly influenced by the barriers described, for example, providing information about medicines and medical history or checking if health care workers have washed their hands. Previous work on patient involvement in safety predicts that these kinds of barriers will arise and outlines the importance of overcoming them by understanding alternative approaches to empowering patients [13]. This will require ongoing work with these patients to understand which approaches to empowerment would be acceptable to them.…”

“…It also helps patients to prepare optimally before and after surgery. Previous research has identified these as the kind of safety-related behaviors that should be incorporated into interventions designed to enhance patient involvement in safety [13][14][15]. The interventional rationale behind MySurgery is much in keeping with that of enhanced recovery programs, which are evidence-based perioperative programs that employ a multidisciplinary and multimodal approach based on implementing a checklist of actions that help resolve issues that delay recovery and cause complications [16].…”

Patient-completed safety checklists as an empowerment tool for patient involvement in patient safety: concepts, considerations and recommendations

“…One addressing safety issues, important information and preparations pre-surgery; the second guiding patients through the discharge process by encouraging them to ask for important information regarding complications, medications, further treatment and follow-up post-surgery. 31,32 Two patient-completed checklists were identified outside of surgical care. The first has been developed to assist elderly inpatients to participate in their discharge planning and make practical arrangements for living at home.…”

An audible patient voice: How can we ensure that patients are treated as partners in their own safety?

“…In medical care, cautious signs of such a shift are visible: using vital sign monitors during the COVID-19 pandemic, checklists for safer surgery, and accessing clinical records to document their own symptoms and views. [8][9][10] A rising number of patients with chronic healthcare conditions in the UK are mastering the self-administration of complex and time sensitive medication at home while being wary that they are denied the ability to exercise this task in hospital. 11 In all these instances, the gap between patients and healthcare professionals is narrowing.…”