Surgical Safety Checklist Compliance: A Job Done Poorly!

Sparks, Eric A.; Wehbe–Janek, Hania; Johnson, Rebecca L.; Smythe, W. Roy; Papaconstantinou, Harry T.

doi:10.1016/j.jamcollsurg.2013.07.393

Cited by 57 publications

(55 citation statements)

References 15 publications

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“…Ten studies used direct independent observation in evaluating team member completion of SSC 18,[19][20][21][22][23][24][25] ; two of these had trained medical student observers while the remaining studies involved nurses and other trained medical staff. Retrospective chart reviews were used to determine rate of compliance in 2 studies, 26,27 1 adding data from a concurrent observational study.…”

Section: Compliance and Adherence Studiesmentioning

confidence: 99%

“…The results indicated that in 8 out of the 13 studies, 16 checklist rates of initiation were .90%, 16,19,[21][22][23][24][25][26] indicating a significant rate of compliance (.90%), based on assessment of previous studies and standards executed by the WHO in SSC administration. 29,30 Vogt et al 21 noted an initiation rate of 100%.…”

Section: Compliance and Adherence Studiesmentioning

confidence: 99%

“…18,19,21,24,27 These findings illustrate the informal ''tick and flick'' attitude toward SSC completion that impedes the effectiveness of the SSC. 22 Considering this difference between documented and observed compliance rates, some studies have suggested ways of building on and improving the existing WHO-SSC. 27 For example, staff could be asked to determine the status or value of an ''anticipated critical event'' or ''completion of instrumental count.''…”

Section: Staff Perceptionmentioning

confidence: 99%

“…16,18,19,[22][23][24]26,27,31 Completion rates ranged from 28.4% in the study by Saturno et al 27 to 85% for Sparks et al, 22 not accounting for accuracy of completion. In the study by Sparks et al, 22 a high completion rate (85%) was negated by a low accuracy rate of 54%, associated with direct observation. A consistent difference of .25% between initiation and compliance rates was a recurrent phenomenon across studies by Cullati et al, 31 Fourcade et al, 26 Levy et al 23 and Saturno et al…”

mentioning

confidence: 90%

“…22,25 Across the studies, verification or introduction of team members at the outset of the checklist was marginally compliant (.80%) in 4 out of the 7 studies that assessed this parameter. Levy Assessment of other aspects of the SCC was also explored in 4 studies.…”

mentioning

confidence: 98%

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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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Section: Compliance and Adherence Studiesmentioning

confidence: 99%

Section: Compliance and Adherence Studiesmentioning

confidence: 99%

Section: Staff Perceptionmentioning

confidence: 99%

mentioning

confidence: 90%

mentioning

confidence: 98%

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

Wangoo

Ray

2016

International Surgery

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Sustainability and Long-term Effectiveness of the WHO Surgical Safety Checklist Combined With Pulse Oximetry in a Resource-Limited Setting

Kim¹,

Kwakye

Kwok

et al. 2015

JAMA Surg

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Sustained use of the checklist was observed with continued improvements in process measures and reductions in 30-day surgical complications almost 2 years after a structured implementation effort that demonstrated marked, short-term reductions in harm. The sustained effect occurred despite the absence of continued oversight by the research team, indicating the important role that local leadership and local champions play in the success of quality improvement initiatives, especially in resource-limited settings.

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A Systematic Review of Interventions Used to Enhance Implementation of and Compliance With the World Health Organization Surgical Safety Checklist in Adult Surgery

Liu¹,

Mehigan²

2021

AORN Journal

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The focus of this systematic review is to identify and synthesize the evidence for effectiveness of interventions to increase compliance with the World Health Organization Surgical Safety Checklist (SSC) for adult surgery. We searched a variety of databases and identified 24 peer‐reviewed articles of either a quantitative (n = 17), qualitative (n = 4), or mixed‐methods design (n = 3) published in English from January 1, 2008, to July 8, 2020. Interventions included modifying the ways of delivering the SSC, integrating or tailoring the SSC to local context or existing practice, promoting clinician awareness and engagement, and managing policies. Despite a lack of common outcome measures, all quantitative and mixed‐methods study results showed a significant positive effect on SSC compliance. A few researchers reported nonsignificant or negative changes in certain aspects with the interventions. Additional research is needed to address SSC compliance measures globally and outcomes in developing countries.

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Surgical Safety Checklist Compliance: A Job Done Poorly!

Cited by 57 publications

References 15 publications

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

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

Sustainability and Long-term Effectiveness of the WHO Surgical Safety Checklist Combined With Pulse Oximetry in a Resource-Limited Setting

A Systematic Review of Interventions Used to Enhance Implementation of and Compliance With the World Health Organization Surgical Safety Checklist in Adult Surgery

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