Society of University SurgeonsMultifaceted interventions improve adherence to the surgical checklist
Section snippets
Context
Children's Memorial Hermann Hospital (CMHH) is an academic, 240-bed children's hospital within the tertiary Memorial Hermann Hospital—Texas Medical Center. CMHH is 1 of 11 hospitals in the Memorial Hermann Hospital system. More than 5,500 operations are performed annually. Fourteen different pediatric specialties were observed during the study period. OR personnel, such as scrub technologists and circulating nurses, are dedicated to either adult or pediatric cases and do not crossover. For each
Results
The pre-incisional checklist performance was assessed for 873 operations (baseline [2011], 144; observation #1 [2012], 373; observation #2 [2013], 356). Adherence to the checklist significantly improved after each interventional period (from 30% to 76% to 96%; P < .001; Fig 1). The different components of the interventions and their temporal relationships to improved adherence are noted in Fig 2. The percentage of operations in which all 14 checkpoints were completed increased from 0% to 19% to
Discussion
This study demonstrated that interventions targeted to improve the culture of safety, local engagement of stakeholders, and comprehension of the checklist significantly improved checklist adherence from 30% to 96% over the course of 2 years. Disseminated protocols and guidelines rarely lead to actual practice changes, and the success is dependent largely on the implementation strategies employed.4, 13 Gonzales et al13 developed a 3-part conceptual framework for translating evidence successfully
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Cited by (43)
Implementation research
2023, Handbook for Designing and Conducting Clinical and Translational SurgeryManaging a team in the operating room: The science of teamwork and non-technical skills for surgeons
2022, Current Problems in SurgeryPerceptions from nurses, surgeons, and anesthetists about the use and benefits of the surgical checklist in a teaching hospital
2022, Journal of Healthcare Quality ResearchImplementation of a Parent-centered Approach to the Preinduction Checklist in Pediatric Surgery
2021, Journal of Surgical ResearchAdherence to the Pediatric Preinduction Checklist Is Improved When Parents Are Engaged in Performing the Checklist
2018, Surgery (United States)Citation Excerpt :Prior studies have demonstrated that successful implementation of the WHO SSC depends on its adaptation to local needs and the degree of stakeholder engagement in its development.9,11 Our preinduction SSC and process was created by our Pediatric OR Safety Council, which includes surgeons (KT, ALK), anesthesiologists, and nurses.8,9 As a group, we decided that having the anesthesia provider (attending or fellow) and the circulating nurse was sufficient for the preinduction checklist.