Table 4 Observed process deviations and correspondence to prototype checklist
Deviations*Corresponding to item on checklistNot corresponding to item on checklistNot suitable for checklist
Preoperative (n = 130)217 (98%)1 (1%)3 (1%)
    Informed consent procedure39
    Informed consent anaesthesia58
    Instructions anaesthesiologist6
    Laboratory tests and blood products18
    Pressure area protection protocol39
    Medication (including premedication)422
Peroperative (n = 171)110 (44%)18 (7%)122 (49%)
    Logistics OR, positioning of patient67
    Instruments/material/equipment presence2997
    Instruments/material/equipment functioning5852
Postoperative (n = 130)114 (93%)1 (1%)7 (6%)
    Operation report in medical record4
    Instructions surgeon12
    Instructions anaesthesiologist16
    (Protocol) information5511
    Discharge letter/outpatient appointments13
    Medication at discharge14
Total441 (74%)20 (3%)132 (22%)
Percentage of matching when considering only deviations suitable for checklist use441/(593–132) = 96%
  • *Deviations represent not adverse events but merely deviations from the optimal and/or appropriate care process and imply potential safety hazard. The outcome of the deviations was not monitored.