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Published in: World Journal of Surgery 6/2020

01-06-2020 | Original Scientific Report

Everyone has Their Role to Play During the World Health Organisation Surgical Safety Checklist in Australia: A Prospective Observational Study

Authors: Christina Taplin, Linda Romano, Mark Tacey, Russell Hodgson

Published in: World Journal of Surgery | Issue 6/2020

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Abstract

Background

The World Health Organisation Surgical Safety Checklist (SSC) is a mandated part of surgical practice. Adherence to the SSC has been shown to result in improved patient outcomes. The aim of this study was to determine the current adherence to the timeout section of the SSC and, in particular, the function of individual team members.

Methods

A prospective pre- and post-intervention observational audit was conducted on the timeout section. The intervention involved an in-hospital display of interim results and distribution to theatre staff. Data were collected on participants, duration and compliance with checklist items for 400 theatre cases. There were 200 cases before and after the intervention.

Results

There were no cases in which the timeout section was completed correctly in its entirety. Post-intervention, there was a significant improvement in participation of theatre staff (excluding surgeons) as well as a significant improvement in items discussed and documented. Discussion of items such as anticipated critical events, pressure areas and the team introduction remained low. Some items on the checklist were discussed significantly more when a particular staff member participated.

Conclusion

Observed completion rates of the timeout section of the SSC were poor. Individual team members positively influenced checklist items more aligned to their role, highlighting the importance of timeout being performed by the entire theatre team. Improved performance was seen following audit and feedback.
Literature
1.
go back to reference Weiser TG, Regenbogen SE, Thompson KD et al (2008) An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet 372:139–144CrossRef Weiser TG, Regenbogen SE, Thompson KD et al (2008) An estimation of the global volume of surgery: a modelling strategy based on available data. Lancet 372:139–144CrossRef
3.
go back to reference Gawande AA, Thomas EJ, Zinner MJ et al (1999) The incidence and nature of surgical adverse events in Colorado and Utah in 1992. Surgery 126:66–75CrossRef Gawande AA, Thomas EJ, Zinner MJ et al (1999) The incidence and nature of surgical adverse events in Colorado and Utah in 1992. Surgery 126:66–75CrossRef
4.
go back to reference Kable AK, Gibberd RW, Spigelman AD (2002) Adverse events in surgical patients in Australia. Int J Qual Health Care 14:269–276CrossRef Kable AK, Gibberd RW, Spigelman AD (2002) Adverse events in surgical patients in Australia. Int J Qual Health Care 14:269–276CrossRef
5.
go back to reference Fudickar A, Horle K, Wiltfang J et al (2012) The effect of the WHO Surgical Safety Checklist on complication rate and communication. Dtsch Arztebl Int 109:695–701PubMedPubMedCentral Fudickar A, Horle K, Wiltfang J et al (2012) The effect of the WHO Surgical Safety Checklist on complication rate and communication. Dtsch Arztebl Int 109:695–701PubMedPubMedCentral
6.
go back to reference Haynes AB, Weiser TG, Berry WR et al (2009) A Surgical Safety Checklist to reduce morbidity and mortality in a global population. N Engl J Med 360:491–499CrossRef Haynes AB, Weiser TG, Berry WR et al (2009) A Surgical Safety Checklist to reduce morbidity and mortality in a global population. N Engl J Med 360:491–499CrossRef
7.
go back to reference Haugen AS, Sevdalis N, Softeland E (2019) Impact of the World Health Organization Surgical Safety Checklist on patient safety. Anesthesiology 131:420–425CrossRef Haugen AS, Sevdalis N, Softeland E (2019) Impact of the World Health Organization Surgical Safety Checklist on patient safety. Anesthesiology 131:420–425CrossRef
8.
go back to reference Mazzocco K, Petitti DB, Fong KT et al (2009) Surgical team behaviors and patient outcomes. Am J Surg 197:678–685CrossRef Mazzocco K, Petitti DB, Fong KT et al (2009) Surgical team behaviors and patient outcomes. Am J Surg 197:678–685CrossRef
9.
go back to reference Nugent E, Hseino H, Ryan K et al (2013) The Surgical Safety Checklist survey: a national perspective on patient safety. Ir J Med Sci 182:171–176CrossRef Nugent E, Hseino H, Ryan K et al (2013) The Surgical Safety Checklist survey: a national perspective on patient safety. Ir J Med Sci 182:171–176CrossRef
10.
go back to reference Helmio P, Blomgren K, Takala A et al (2011) Towards better patient safety: WHO Surgical Safety Checklist in otorhinolaryngology. Clin Otolaryngol 36:242–247CrossRef Helmio P, Blomgren K, Takala A et al (2011) Towards better patient safety: WHO Surgical Safety Checklist in otorhinolaryngology. Clin Otolaryngol 36:242–247CrossRef
11.
go back to reference Russ SJ, Sevdalis N, Moorthy K et al (2015) A qualitative evaluation of the barriers and facilitators toward implementation of the WHO Surgical Safety Checklist across hospitals in England: lessons from the “Surgical Checklist Implementation Project”. Ann Surg 261:81–91CrossRef Russ SJ, Sevdalis N, Moorthy K et al (2015) A qualitative evaluation of the barriers and facilitators toward implementation of the WHO Surgical Safety Checklist across hospitals in England: lessons from the “Surgical Checklist Implementation Project”. Ann Surg 261:81–91CrossRef
12.
go back to reference Haugen AS, Waehle HV, Almeland SK et al (2019) Causal analysis of World Health Organization’s Surgical Safety Checklist implementation quality and impact on care processes and patient outcomes: secondary analysis from a large stepped wedge cluster randomized controlled trial in Norway. Ann Surg 269:283–290CrossRef Haugen AS, Waehle HV, Almeland SK et al (2019) Causal analysis of World Health Organization’s Surgical Safety Checklist implementation quality and impact on care processes and patient outcomes: secondary analysis from a large stepped wedge cluster randomized controlled trial in Norway. Ann Surg 269:283–290CrossRef
13.
go back to reference Weiser TG, Haynes AB, Dziekan G et al (2010) Effect of a 19-item Surgical Safety Checklist during urgent operations in a global patient population. Ann Surg 251:976–980CrossRef Weiser TG, Haynes AB, Dziekan G et al (2010) Effect of a 19-item Surgical Safety Checklist during urgent operations in a global patient population. Ann Surg 251:976–980CrossRef
14.
go back to reference Giles K, Munn Z, Aromataris E et al (2017) Use of Surgical Safety Checklists in Australian operating theatres: an observational study. ANZ J Surg 87:971–975CrossRef Giles K, Munn Z, Aromataris E et al (2017) Use of Surgical Safety Checklists in Australian operating theatres: an observational study. ANZ J Surg 87:971–975CrossRef
16.
go back to reference Gillespie BM, Marshall AP, Gardiner T et al (2016) Impact of workflow on the use of the Surgical Safety Checklist: a qualitative study. ANZ J Surg 86:864–867CrossRef Gillespie BM, Marshall AP, Gardiner T et al (2016) Impact of workflow on the use of the Surgical Safety Checklist: a qualitative study. ANZ J Surg 86:864–867CrossRef
17.
go back to reference Borchard A, Schwappach DL, Barbir A et al (2012) A systematic review of the effectiveness, compliance, and critical factors for implementation of safety checklists in surgery. Ann Surg 256:925–933CrossRef Borchard A, Schwappach DL, Barbir A et al (2012) A systematic review of the effectiveness, compliance, and critical factors for implementation of safety checklists in surgery. Ann Surg 256:925–933CrossRef
19.
go back to reference Ziman R, Espin S, Grant RE et al (2018) Looking beyond the checklist: an ethnography of interprofessional operating room safety cultures. J Interprof Care 32:575–583CrossRef Ziman R, Espin S, Grant RE et al (2018) Looking beyond the checklist: an ethnography of interprofessional operating room safety cultures. J Interprof Care 32:575–583CrossRef
20.
go back to reference Urbach DR, Govindarajan A, Saskin R et al (2014) Introduction of Surgical Safety Checklists in Ontario, Canada. N Engl J Med 370:1029–1038CrossRef Urbach DR, Govindarajan A, Saskin R et al (2014) Introduction of Surgical Safety Checklists in Ontario, Canada. N Engl J Med 370:1029–1038CrossRef
21.
go back to reference Conley DM, Singer SJ, Edmondson L et al (2011) Effective Surgical Safety Checklist implementation. J Am Coll Surg 212:873–879CrossRef Conley DM, Singer SJ, Edmondson L et al (2011) Effective Surgical Safety Checklist implementation. J Am Coll Surg 212:873–879CrossRef
22.
go back to reference Gillespie BM, Harbeck EL, Lavin J et al (2018) Evaluation of a patient safety programme on Surgical Safety Checklist Compliance: a prospective longitudinal study. BMJ Open Qual 7:e000362CrossRef Gillespie BM, Harbeck EL, Lavin J et al (2018) Evaluation of a patient safety programme on Surgical Safety Checklist Compliance: a prospective longitudinal study. BMJ Open Qual 7:e000362CrossRef
23.
go back to reference Helmio P, Takala A, Aaltonen LM et al (2012) WHO Surgical Safety Checklist in otorhinolaryngology-head and neck surgery: specialty-related aspects of check items. Acta Otolaryngol 132:1334–1341CrossRef Helmio P, Takala A, Aaltonen LM et al (2012) WHO Surgical Safety Checklist in otorhinolaryngology-head and neck surgery: specialty-related aspects of check items. Acta Otolaryngol 132:1334–1341CrossRef
Metadata
Title
Everyone has Their Role to Play During the World Health Organisation Surgical Safety Checklist in Australia: A Prospective Observational Study
Authors
Christina Taplin
Linda Romano
Mark Tacey
Russell Hodgson
Publication date
01-06-2020
Publisher
Springer International Publishing
Published in
World Journal of Surgery / Issue 6/2020
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-020-05397-2

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