Observations of Pre-operative Teamwork and Communication During the Implementation of a City-Wide Surgical Safety Checklist

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dc.contributor.author Hansen, Terry Leonid
dc.contributor.author Goerl, Kyle
dc.contributor.author Fears, Reginald
dc.contributor.author Nguyen, Tim
dc.contributor.author Hart, Traci
dc.contributor.author Uhlig, Paul
dc.date.accessioned 2012-11-27T14:24:51Z
dc.date.available 2012-11-27T14:24:51Z
dc.date.issued 2012-11-27
dc.identifier.uri http://hdl.handle.net/2271/1114
dc.description.abstract BACKGROUND: Use of the World Health Organization's (WHO) perioperative safety checklist has been shown in prior studies to reduce morbidity and mortality. In 2009, the Medical Society of Sedgwick County, Kansas, developed a modified version of the WHO checklist for city-wide implementation. This study evaluated how the checklist was used at a Wichita hospital. METHODS: An observational tool was developed to evaluate time-outs at the beginning of surgical procedures. A convenience sample of cases was evaluated across surgical specialties and procedures. Observations included: 1) when the time-out was done, 2) who led the time-out, 3) which items on the checklist were addressed, 4) how much time was spent, and 5) whether problems were identified or adverse events prevented. RESULTS: Data were collected from 121 observations. Only one of the surgical teams was observed to refer directly to the checklist posted in the OR to conduct their time out. The time-out was done before induction (3%), drape (19%), incision (77%), and after incision (1%). The process was led by the circulating nurse (92%), surgeon (7%), and circulating nurse and surgeon together (1%). The percent of completed checklist items was: patient identity (96%), procedure (96%), antibiotics (87%), site (80%), allergies (75%), position (70%), equipment (60%), DVT prevention (50%), images (40%), surgeon concerns (36%), and anesthesia provider concerns (34%). On average, seven (SD = 2.5) of 11 items on the checklist were addressed. Time spent ranged from less than one minute to five minutes; 78% took one minute or less. Problems were identified in 7% of cases. In one case, a wrong site surgery was prevented. CONCLUSIONS: Despite the intention to implement a city-wide surgical safety checklist, the checklist rarely was used in its entirety to conduct the observed time-outs in the subject hospital. Although the checklist was under-utilized, safety benefits were observed from the time-out process. These would likely be enhanced and extended by consistent use of a checklist. en_US
dc.subject.mesh patient safety
dc.subject.mesh preoperative period
dc.subject.mesh interdisciplinary communication
dc.subject.mesh patient care team
dc.title Observations of Pre-operative Teamwork and Communication During the Implementation of a City-Wide Surgical Safety Checklist en_US
dc.type Article en_US
rft.spage 117 en_US
dc.contributor.organization University of Arkansas for Medical Sciences en_US
dc.ispartof.issn 1948-2035
dc.ispartof.issue 4 en_US
dc.ispartof.title Publication::Kansas Journal of Medicine en_US
dc.ispartof.volume 5 en_US

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