AIM: Recent studies have demonstrated a reduction in perioperative complications if a surgical safety checklist is utilised. In our institution an adaptation of the WHO Surgical Safety Checklist is administered in 3 "domains": on arrival of the patient in the operating room (Sign In); before surgical incision (Time Out) and before the patients leaves the operating room (Sign Out). Since incomplete administration or staff disengagement could diminish any safety benefit we evaluated administration of this checklist. METHOD: 100 adult surgical cases were observed. Compliance with administration of the Sign In, Time Out, and Sign Out domains and their component checklist items was recorded. The timing of the checklist administration, and engagement of operating room teams were also assessed. RESULTS: The rate (per 100 cases) of the checklist domain administration was: 99 for Sign In; 94 for Time Out; and 2 for Sign Out. The mean (range) checklist item compliance was 56% (27-100%) for Sign In, 69% (33-100%) for Time Out, and 40% for Sign Out. Checklist items related to patient identity and surgical procedure were administered in 100% of Sign In administrations. Timing of the checklist administration was appropriate in over 80% of cases. Engagement by theatre teams was frequently incomplete. CONCLUSION: The Sign Out domain was almost always omitted, which may increase the risk of important omissions in postoperative care. Most other aspects of checklist administration could also be improved. This will require strong leadership from senior clinicians in all relevant teams.
AIM: Recent studies have demonstrated a reduction in perioperative complications if a surgical safety checklist is utilised. In our institution an adaptation of the WHO Surgical Safety Checklist is administered in 3 "domains": on arrival of the patient in the operating room (Sign In); before surgical incision (Time Out) and before the patients leaves the operating room (Sign Out). Since incomplete administration or staff disengagement could diminish any safety benefit we evaluated administration of this checklist. METHOD: 100 adult surgical cases were observed. Compliance with administration of the Sign In, Time Out, and Sign Out domains and their component checklist items was recorded. The timing of the checklist administration, and engagement of operating room teams were also assessed. RESULTS: The rate (per 100 cases) of the checklist domain administration was: 99 for Sign In; 94 for Time Out; and 2 for Sign Out. The mean (range) checklist item compliance was 56% (27-100%) for Sign In, 69% (33-100%) for Time Out, and 40% for Sign Out. Checklist items related to patient identity and surgical procedure were administered in 100% of Sign In administrations. Timing of the checklist administration was appropriate in over 80% of cases. Engagement by theatre teams was frequently incomplete. CONCLUSION: The Sign Out domain was almost always omitted, which may increase the risk of important omissions in postoperative care. Most other aspects of checklist administration could also be improved. This will require strong leadership from senior clinicians in all relevant teams.
Authors: Jennifer M Weller; Tanisha Jowsey; Carmen Skilton; Derryn A Gargiulo; Oleg N Medvedev; Ian Civil; Jacqueline A Hannam; Simon J Mitchell; Jane Torrie; Alan F Merry Journal: BMJ Open Date: 2018-12-16 Impact factor: 2.692
Authors: Michelle C White; Kirsten Randall; Vaonandianina A Ravelojaona; Hery H Andriamanjato; Vanessa Andean; James Callahan; Mark G Shrime; Stephanie Russ; Andrew J M Leather; Nick Sevdalis Journal: BMJ Glob Health Date: 2018-12-20
Authors: Mary E Brindle; Natalie Henrich; Andrew Foster; Stanley Marks; Michael Rose; Robert Welsh; William Berry Journal: BMC Health Serv Res Date: 2018-03-27 Impact factor: 2.655
Authors: Brigid M Gillespie; Emma L Harbeck; Joanne Lavin; Kyra Hamilton; Therese Gardiner; Teresa K Withers; Andrea P Marshall Journal: BMJ Open Qual Date: 2018-07-12