Thirty-Day Outcomes Support Implementation of a Surgical Safety Checklist

Bliss, Lindsay A.; Ross-Richardson, Cynthia; Sanzari, Laura; Shapiro, David S.; Lukianoff, Alexandra E.; Bernstein, Bruce; Ellner, Scott J.

doi:10.1016/j.jamcollsurg.2012.07.015

Cited by 143 publications

(159 citation statements)

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“…A landmark study published in 2009 illustrated that the implementation of the WHO SSC in varied socioeconomic settings worldwide was associated with marked improvements in surgical outcomes, including significant reductions in morbidity and mortality. 6 Numerous studies published since then have shown similar results, [7][8][9][10] and consequently the SSC has seen rapid and widespread adoption. 11 Many of these studies have shown compliance to be the most important factor for improved mortality and morbidity.…”

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confidence: 65%

Attitudes and beliefs about the surgical safety checklist: Just another tick box?

Dharampal

Cameron

Dixon

et al. 2016

cjs

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Background: Following a landmark study showing decreased morbidity and mortality after implementation of the surgical safety checklist (SSC), it has been widely adopted into perioperative policy. We explored the impact of attitudes and beliefs surrounding the SSC on its uptake in Calgary. Methods:We used qualitative methodology to examine factors influencing SSC use. We performed semistructured interviews based on Rogers' theory of diffusion of innovation. Purposive and snowball sampling were used to identify surgeons, anesthesiologists and operating room nurses from hospitals in Calgary. Data collection and analysis were based on grounded theory. Two individuals jointly analyzed data and achieved consensus on emerging themes.Results: Generated themes included 1) the SSC has brought organization to previous informal perioperative checks, 2) the SSC is most helpful when it is simple, and 3) the 3 current components of the checklist are redundant. The briefing was considered the most important aspect and the debriefing the least important. Initially the SSC was difficult to implement owing to a shift in time management and perioperative culture; however, it has now assimilated into perioperative routine. Finally, though most participants agreed that the SSC might avoid some delays and complications, only a few believe there have been observable improvements to morbidity and mortality. Conclusion:Although the SSC has been integrated into perioperative practice in Calgary, participants believe that previous informal checkpoints were able to circumvent most perioperative issues. Although the SSC may help with flow and equipment, participants believe it fails to show a subjective, clinically important improvement.Contexte : Après une étude charnière ayant montré une baisse de la morbidité et de la mortalité après la mise en oeuvre de la liste de contrôle de la sécurité chirurgicale, cette dernière a été largement intégrée aux politiques périopératoires. Nous avons examiné l'effet des attitudes et des croyances entourant la liste sur son adoption à Calgary.Méthodes : À l'aide d'une méthode qualitative, nous nous sommes penchés sur les facteurs influençant l'utilisation de la liste. Pour ce faire, nous avons effectué des entrevues semi-dirigées fondées sur la théorie de la diffusion de l'innovation de Rogers. Nous avons utilisé l'échantillonnage dirigé et le sondage en boule de neige pour cibler des chirurgiens, des anesthésiologistes et des membres du personnel infirmier de salle d'opération des hôpitaux de Calgary. La collecte et l'analyse des données étaient fondées sur la théorie ancrée. Deux personnes ont analysé ensemble les données et se sont entendues sur les thèmes émergents.Résultats : Voici les principales conclusions dégagées : 1) la liste a permis de structurer les contrôles périopératoires non officiels du passé, 2) la liste est surtout utile quand elle est simple et 3) les 3 composantes actuelles de la liste de contrôle sont redondantes. Le breffage était considéré comme étant l'aspect le plus important e...

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confidence: 65%

Attitudes and beliefs about the surgical safety checklist: Just another tick box?

Dharampal

Cameron

Dixon

et al. 2016

cjs

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“…Bliss LA, et al 20 The general conclusion is that there was a statistically significant reduction in rates of adverse events and complications.…”

Section: Resultsmentioning

confidence: 98%

“…One of the requirements to provide quality care and safe is to have an open communication culture, allowing teams an equal relationship where hierarchical rivalries become irrelevant. 19,20, In this sense, evidence communication as relevant factors to patient safety culture in health institutions is critical to the development of the work. The use of surgical safety checklist provides an opportunity for effective communication, allowing members of the surgical team to share expectations and clear and correct information reducing threats and complications.…”

Section: Vivekanantham S Et Al 26mentioning

confidence: 99%

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Surgical safety checklist: An integrative review of the benefits and importance / Lista de verificação de segurança cirúrgica: Uma revisão integrativa sobre benefícios e sua importância

Mafra

Rodrigues

2018

R. pesq. cuid. fundam. online

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Objetivo: Analisar, com base na literatura, os benefícios da implantação da lista de verificação de segurança cirúrgica. Método: revisão integrativa norteada pela questão: “Quais os benefícios da utilização da lista de verificação de segurança cirúrgica segura para a melhoria na qualidade em serviços de saúde?”. O levantamento dos artigos foi realizado em base de dados Medline via Pub Med, Lilacs, Bdenf via Biblioteca Virtual em Saúde, publicados no período de 2010 a 2014. Resultados: Mediante os achados emergiram o agrupamento por similaridade de resultados “benefícios da utilização da lista de verificação de segurança cirúrgica” e “importância da lista de verificação de segurança cirúrgica na redução da morbidade iatrogênica causando desfechos indesejáveis”. Conclusão: A análise permitiu evidenciar que a implementação da lista de verificação da cirurgia segura está associada a melhores resultados e estabelece processos seguros na assistência cirúrgica. Descritores: Lista de checagem, Segurança do paciente, Salas cirúrgicas.

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“…This was a powerful effect from a simple intervention which led to many developed nations mandating the use of checklists in their hospitals as a mechanism to achieve zero error. Its effect, however, remains unclear ; subsequent studies have failed to show reduction in morbidity and mortality of the kind shown by the original WHO study [2,3] and only studies which incorporated team training [4,5] and used multiple checklists, in a more comprehensive patient safety system, have shown results similar to the index WHO study [6]. In the most recent study of the value of a safety checklist in Ontario, Canada, Urbach et al [7] did not show the improvement in outcomes seen in previous studies, although these authors conceded that a greater effect of safety checklists may arise with intensive training of staff and better monitoring of compliance.…”

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confidence: 99%

A culture of change - hospital safety check lists

Deen¹

2014

Sri Lanka j Surg

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A culture of change -hospital safety check listsThe world over, hospitals are including safety of patients as a measure of surgical care and a requirement for accreditation. Operating rooms have come under the hammer of the World Health Organization (WHO) in a global attempt to reduce error. The WHO surgical safety checklist generic document aims to ensure that the correct patient is being operated upon, that the checklist prevents wrong site surgery, and focuses on appropriate and timely antibiotic prophylaxis -the omission of which creates a huge impact on healthcare economics and spread of hospital acquired infection. Secondary beneficial effects of operating room safety checks are thought to be, harnessing a team approach among operating room staff and to ensure that equipment is in good working order. The WHO recommends modifications to the checklist to suit local conditions which may vary widely within the country and from one operating room to the other. The evidenceA study published in 2009 revealed that implementation of the WHO -19 item check list resulted in reduction of surgical complications from 11 to 7 percent, and reduced hospital mortality from 1.5 to 0.8 percent [1]. This was a powerful effect from a simple intervention which led to many developed nations mandating the use of checklists in their hospitals as a mechanism to achieve zero error. Its effect, however, remains unclear ; subsequent studies have failed to show reduction in morbidity and mortality of the kind shown by the original WHO study [2,3] and only studies which incorporated team training [4,5] and used multiple checklists, in a more comprehensive patient safety system, have shown results similar to the index WHO study [6]. In the most recent study of the value of a safety checklist in Ontario, Canada, Urbach et al [7] did not show the improvement in outcomes seen in previous studies, although these authors conceded that a greater effect of safety checklists may arise with intensive training of staff and better monitoring of compliance. Mere implementation of a safety checklist by filling in tick boxes may not achieve the aims of its pioneers, and requires the diligence and compliance of all team members to ensure that patient safety is taken way beyond the operating room into a safe environment of post-operative care on the wards, until the patient is finally discharged from hospital. And there are other matters that affect patient safety, such as, intra-operative surgical decision making, which ultimately affects patient outcomes in a manner that is far worse than the omission of surgical safety tick boxing -in a discussion focused on prevention of bile duct injury during laparoscopic cholecystectomy, it becomes apparent that better communication between the surgeon and the team in the operating room may have averted bile duct injury [8]. Up to now, the literature has not addressed the issue of safety check lists and "near misses" in the operating room. Near misses -which are defined as errors or malfunctions that might well ha...

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Thirty-Day Outcomes Support Implementation of a Surgical Safety Checklist

Cited by 143 publications

References 16 publications

Attitudes and beliefs about the surgical safety checklist: Just another tick box?

Attitudes and beliefs about the surgical safety checklist: Just another tick box?

Surgical safety checklist: An integrative review of the benefits and importance / Lista de verificação de segurança cirúrgica: Uma revisão integrativa sobre benefícios e sua importância

A culture of change - hospital safety check lists

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