Surgical Checklist Implementation Project

Mayer, Erik; Sevdalis, Nick; Rout, Shantanu; Caris, Jochem; Russ, Stephanie; Mansell, Jenny; Davies, Rachel; Skapinakis, Petros; Vincent, Charles; Athanasiou, Thanos; Moorthy, Krishna; Darzi, Ara

doi:10.1097/sla.0000000000001185

Cited by 126 publications

(63 citation statements)

References 15 publications

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“…In our study, assessment of the risk of major blood loss, antibiotic prophylaxis given before skin incision, and use of a pulse oximeter (86% of participants) were the most common sustained practice changes at 15 months. It is significant that our participants also experienced positive changes in attitude related to teamwork, organisation and communication, because some studies show that partial completion of the SSC due to poor attitudes can substantially negate the benefits [17]. …”

Section: Discussionmentioning

confidence: 99%

Interval follow up of a 4-day pilot program to implement the WHO surgical safety checklist at a Congolese hospital

et al. 2017

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BackgroundThe World Health Organisation Surgical Safety Checklist (SSC) improves surgical outcomes and the research question is no longer ‘does the SSC work?’ but, ‘how to make the SSC work?’ Evidence for implementation strategies in low-income countries is sparse and existing strategies are heavily based on long-term external support. Short but effective implementation programs are required if widespread scale up is to be achieved. We designed and delivered a four-day pilot SSC training course at a single hospital centre in the Republic of Congo, and evaluated the implementation after one year. We hypothesised that participants would still be using the checklist over 50% of the time.MethodWe taught the four-day SSC training course at Dolisie hospital in February 2014, and undertook a mixed methods impact evaluation based on the Kirkpatrick model in May 2015. SSC implementation was evaluated using self-reported questionnaire with a 3 point Likert scale to assess six key process measures. Learning, behaviour, organisational change and facilitators and inhibitors to change were evaluated with questionnaires, interviews and focus group discussion.ResultsSeventeen individuals participated in the training and seven (40%) were available for impact evaluation at 15 months. No participant had used the SSC prior to training. Over half the participants were following the six processes measures always or most of the time: confirmation of patient identity and the surgical procedure (57%), assessment of difficult intubation risk (72%), assessment of the risk of major blood loss (86%), antibiotic prophylaxis given before skin incision (86%), use of a pulse oximeter (86%), and counting sponges and instruments (71%). All participants reported positive improvements in teamwork, organisation and safe anesthesia. Most participants reported they worked in helpful, supportive and respectful atmosphere; and could speak up if they saw something that might harm a patient. However, less than half felt able to challenge those in authority.ConclusionOur study demonstrates that a 4-day pilot course for SSC implementation resulted in over 50% of participants using the SSC at 15 months, positive changes in learning, behaviour and organisational change, but less impact on hierarchical culture. The next step is to test our novel implementation strategy in a larger hospital setting.

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Section: Discussionmentioning

confidence: 99%

Interval follow up of a 4-day pilot program to implement the WHO surgical safety checklist at a Congolese hospital

et al. 2017

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“…In another study, they looked at 565 time out and 309 sign out sections of the checklists in five hospitals 5. “But, on average, only two thirds of the items on the checklist were actually checked,” Moorthy said, meaning that many of the safety checks may not have been discussed.…”

Section: Implementation By Edictmentioning

confidence: 99%

WHO’s surgical safety checklist: it ain’t what you do . . .

McLachlan¹

2019

BMJ

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“…Studies of process failures, communication, teamwork, interruptions, and distractions have now identified multiple vulnerabilities in systems of surgical care (Vincent, Moorthy, Sarker, Chang, & Darzi, 2004). These developments have laid the foundation for the development, assessment, and evaluation of team training and the impact of surgical teamwork on patient outcomes (Mayer et al, 2015). Measures of surgical teamwork have been developed which draw on psychological models of teamwork in a variety of settings; some of these approaches have been extensively validated and proved to be psychometrically robust (Sevdalis et al, 2009).…”

Section: Enhancing Teamworkmentioning

confidence: 99%

Making health care safer: What is the contribution of health psychology?

Vincent

Wearden

French

2015

British J Health Psychol

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While health care brings great benefits, all treatments, and many investigations, carry some risk. As patients, we should be told of the risks of specific treatments but we are also at risk from failings in the health care system itself. We suggest that, while there are many examples of individual health psychologists who have made important contributions, this has not yet translated into a broader disciplinary engagement. Health psychologists have devoted much more attention to patients and devoted much less attention to the potentially huge impact of studying and intervening with staff, clinical practice, and organizations. We believe that there are considerable opportunities for health psychology to engage more closely with patient safety and, more importantly, that this would be of great benefit to both patients and staff. Statement of contribution What is already known on this subject? While health care brings great benefits, all treatments, and many investigations, carry some risk. Patients are also at risk from failings in the health care system itself. Studies using review of medical records in many countries have found that between 8% and 12% of patients in hospital suffer an unintended harm due to health care. What does this study add? There are many examples of individual psychologists who have made important contributions, but this has not yet translated into a broader disciplinary engagement. There are considerable opportunities for health psychology to engage more closely with patient safety. These include health behaviour change, teamwork, communication after medical error, diagnosis and decision making, organisational culture, and improving compliance with rules and standards. Psychologists providing a clinical service to specialist services in any area could expand their remit from supporting patients to a more general support and engagement with safety and quality initiatives. Health psychologists have models to understand the behaviour of people, and recent developments in changing behaviour should be applicable to health professionals in addition to their patients.

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Surgical Checklist Implementation Project

Cited by 126 publications

References 15 publications

Interval follow up of a 4-day pilot program to implement the WHO surgical safety checklist at a Congolese hospital

Interval follow up of a 4-day pilot program to implement the WHO surgical safety checklist at a Congolese hospital

WHO’s surgical safety checklist: it ain’t what you do . . .

Making health care safer: What is the contribution of health psychology?

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