RT Journal Article
SR Electronic
T1 A ‘paperless’ wall-mounted surgical safety checklist with migrated leadership can improve compliance and team engagement
JF BMJ Quality & Safety
JO BMJ Qual Saf
FD BMJ Publishing Group Ltd
SP 971
OP 976
DO 10.1136/bmjqs-2015-004545
VO 25
IS 12
A1 Aaron Pin Chien Ong
A1 Daniel A Devcich
A1 Jacqueline Hannam
A1 Tracey Lee
A1 Alan F Merry
A1 Simon J Mitchell
YR 2016
UL http://qualitysafety.bmj.com/content/25/12/971.abstract
AB Background Outcome benefits of using the WHO Surgical Safety Checklist rely on compliance with checklist administration.Objective To evaluate engagement of operating room (OR) subteams (anaesthesia, surgery and nursing), and compliance with administering checklist domains (Sign In, Time Out and Sign Out) and checklist items, after introducing a wall-mounted paperless checklist with migration of process leadership (Sign In, Time Out and Sign Out led by anaesthesia, surgery and nursing, respectively).Methods This was a pre-post observational study in which 261 checklist domains in 111 operations were observed 2 months after changing the checklist administration paradigm. Compliance with administration of the checklist domains and individual checklist items was recorded, as was the number of OR subteams engaged. Comparison was made with 2013 data from the same OR suite prior to the paradigm change.Results Data are presented as 2013 versus the present study. The Sign In, Time Out and Sign Out domains were administered in 96% vs 98% (p=0.69), 99% vs 99% (p=1.00) and 22% vs 84% (p<0.001) of cases, respectively. The percentage of relevant checklist items administered in each domain was 60% vs 92%, 84 vs 93% and 80% vs 99%, respectively (p<0.001 for all comparisons). Two-subteam (or better) engagement at Sign In (surgeons usually absent) was 40% vs 94% of cases. Three-subteam (or all staff present) engagement at Time Out and Sign Out was 15% vs 92% and 9% vs 25% of cases, respectively (p<0.001 for all comparisons).Conclusions Improvements in team engagement and compliance with administering checklist items followed introduction of migrated leadership of checklist administration and a wall-mounted checklist. This paradigm change was relatively simple and inexpensive.