Hostname: page-component-78c5997874-v9fdk Total loading time: 0 Render date: 2024-11-04T19:48:26.580Z Has data issue: false hasContentIssue false
  • English
  • Français

Achieving flying colours in surgical safety: audit of World Health Organization ‘Surgical Safety Checklist’ compliance

Published online by Cambridge University Press:  15 August 2012

Y Sheena ,
J M Fishman ,
C Nortcliff ,
T Mawby ,
A F Jefferis  and
N R Bleach
Y Sheena
Affiliation:
Department of Otolaryngology, Wexham Park Hospital, Slough, UK
J M Fishman*
Affiliation:
Department of Otolaryngology, Wexham Park Hospital, Slough, UK Institute of Child Health, University College London, UK
C Nortcliff
Affiliation:
Department of Otolaryngology, Wexham Park Hospital, Slough, UK
T Mawby
Affiliation:
Department of Otolaryngology, Wexham Park Hospital, Slough, UK
A F Jefferis
Affiliation:
Oxford Deanery, Headington, UK
N R Bleach
Affiliation:
Department of Otolaryngology, Wexham Park Hospital, Slough, UK
*
Address for correspondence: Mr Jonathan M Fishman, Wexham Park Hospital, Slough SL2 4HL, UK E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

The World Health Organization ‘Surgical Safety Checklist’ has been adopted by UK surgical units following National Patient Safety Agency guidance. Our aim was to assess compliance with our local version of this Checklist.

Methods:

Otolaryngology trainee doctors prospectively assessed compliance with the local Checklist over a six-week period. A staff educational intervention was implemented and the audit was repeated 12 months later.

Results:

A total of 72 cases were assessed. The initial audit found that: 44 per cent of procedures were undocumented at ‘Sign in’; ‘Time out’ was inappropriately interrupted in 39 per cent of cases; the procedure started before Checklist completion in 33 per cent of cases; and the ‘Sign out’ was not read out in 94 per cent of cases and was not fully documented in 42 per cent of cases. Following education, re-audit indicated that overall compliance had improved from 63.7 per cent (±8.9 per cent standard error of the mean) to 90.4 per cent (±2.7 per cent standard error of the mean).

Conclusion:

Our completed audit cycle demonstrated a significant improvement in Checklist compliance following educational intervention. We discuss barriers to compliance, as well as strategies for quality improvement, and we call for other surgeons to similarly publish their Checklist experience and assess its impact on surgical outcomes.

Keywords

OtolaryngologySafetyAuditWorld Health OrganizationChecklistSurgical ProceduresOperative
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 10 , October 2012 , pp. 1049 - 1055
Copyright
Copyright © JLO (1984) Limited 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1WHO surgical safety checklist and implementation manual. In: http://www.who.int/patientsafety/safesurgery/ss_checklist/en/index.html [16 July 2012]Google Scholar
2Degani, A, Wiener, EL. Cockpit checklists: concepts, design, and use. Hum Factors 1993;35:345–59CrossRefGoogle Scholar
3Haynes, AB, Weiser, TG, Berry, WR, Lipsitz, SR, Breizat, AH, Dellinger, EP et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med 2009;360:491–9CrossRefGoogle Scholar
4WHO surgical safety checklist. In: www.nrls.npsa.nhs.uk/resources/?entryid45=59860 [16 July 2012]Google Scholar
5World Health Organization. World Alliance for Patient Safety: Implementation Manual for the Surgical Safety Checklist, 1st edn.Geneva: WHO Press, 2008Google Scholar
6Vats, A, Vincent, CA, Nagpal, K, Davies, RW, Darzi, A, Moorthy, K. Practical challenges of introducing WHO surgical checklist: UK pilot experience. BMJ 2010;340:b5433CrossRefGoogle ScholarPubMed
7Weiser, TG, Haynes, AB, Dziekan, G, Berry, WR, Lipsitz, SR, Gawande, AA. Safe Surgery Saves Lives Investigators and Study Group. Effect of a 19-item surgical safety checklist during urgent operations in a global patient population. Ann Surg 2010;251:976–80CrossRefGoogle Scholar
8Clark, S, Hamilton, L. WHO surgical checklist. Needs to be customised by specialty. BMJ 2010;340:c589CrossRefGoogle ScholarPubMed
9Sewell, M, Adebibe, M, Jayakumar, P, Jowett, C, Kong, K, Vemulapalli, K et al. Use of the WHO surgical safety checklist in trauma and orthopaedic patients. Int Orthop 2011;35:897–901CrossRefGoogle ScholarPubMed
10Abdel-Galil, K. The WHO surgical safety checklist: are we measuring up? Br J Oral Maxillofac Surg 2010;48:397–8CrossRefGoogle ScholarPubMed
11Kearns, RJ, Uppal, V, Bonner, J, Robertson, J, Daniel, M, McGrady, EM. The introduction of a surgical safety checklist in a tertiary referral obstetric centre. BMJ Qual Saf 2011;20:818–22CrossRefGoogle Scholar
12Weiser, TG, Haynes, AB, Lashoher, A, Dziekan, G, Boorman, DJ, Berry, WR et al. Perspectives in quality: designing the WHO surgical safety checklist. Int J Qual Health Care 2010;22:365–70CrossRefGoogle ScholarPubMed
13Karamchandani, D, McGarry, GW. The World Health Organization surgical safety checklist. Clin Otolaryngol 2010;35:217–18CrossRefGoogle Scholar
14Helmiö, P, Blomgren, K, Takala, A, Pauniaho, SL, Takala, RS, Ikonen, TS. Towards better patient safety: WHO surgical safety checklist in otorhinolaryngology. Clin Otolaryngol 2011;36:242–7CrossRefGoogle ScholarPubMed
15Haynes, AB, Weiser, TG, Berry, WR, Lipsitz, SR, Breizat, AH, Dellinger, EP et al. Changes in safety attitude and relationship to decreased postoperative morbidity and mortality following implementation of a checklist-based surgical safety intervention. BMJ Qual Saf 2011;20:102–7CrossRefGoogle ScholarPubMed