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Call 2: Background of the WHO Surgical Safety Checklist. Last Week ’ s Call. Overview of the Safe Surgery 2015: South Carolina Initiative and call series. MUSC ’ s checklist journey. Today ’ s Topics. Building an implementation team. Poll
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Last Week’s Call • Overview of the Safe Surgery 2015: South Carolina Initiative and call series. • MUSC’s checklist journey.
Today’s Topics • Building an implementation team. • Poll • The background of the WHO Surgical Safety Checklist. • Website Overview.
Meeting the Team Lorri Gibbons, RN, BSN, CPHQ Vice President Quality & Patient Safety SCHA
Starting the Journey:Building a Checklist Implementation Team
Build an Implementation Team Administrator/Quality Improvement Officer Anesthesiologist and/or CRNA Circulating Nurse Scrub Tech Surgeon Others (Perfusionists, PA’s, Biomedical Engineers, Anesthesia Techs, Pre-op nursing, etc)
Find Clinical Champions The nurses will know. Pick those who are respected and who will be supportive. The support of “formal” leadership is absolutely necessary but those leaders are often not the ones who should guide this effort directly.
Recommendations on How Often and When to Meet as a Team • Meet regularly. • Choose someone to organize the meeting schedule and be a point of contact for people in your hospital and our team. • An opportune time to meet together would be following each webinar. • It is better to meet with part of the group than not at all.
Poll 1:Pick the most important thing that makes you feel like a case went well. • Respected • My concerns were heard • We had all of the necessary equipment • There were not any delays • All of the paperwork was in order • There were no wasted resources • I had all of the information that I needed to know to take care of the patient • The team worked well together • The case ended on time
Poll 2:Pick all of the things that make a case go well. • Respected • My concerns were heard • We had all of the necessary equipment • There were not any delays • All of the paperwork was in order • The patient did well • There were no wasted resources • I had all of the information that I needed to know to take care of the patient • The team worked well together • The case ended on time
The 3 Central Problems in Surgical Safety Throughout the World Unrecognized as public health issue Lack of data on surgery and outcomes Even though we know what to do, but we don’t do it consistently
Global Annual Procedure Rates Source: WHO, 2008
Guiding Principles Simple Widely applicable Measurable Address serious and avoidable surgical complications Zero harm from the Checklist
International Pilot Study 8 Evaluation Sites - Nearly 8,000 Patients EURO EMRO PAHO I London, UK Amman, Jordan Toronto, Canada WPRO I Manila, Philippines PAHO II Seattle, USA WPRO II AFRO Auckland, NZ Ifakara, Tanzania SEARO New Delhi, India
Survey of Attitudes to Checklist Use Among Clinicians at Study Site (n=229)
SURPASS Checklist The Netherlands 100 item checklist implemented in 6 high performing hospitals Compared to controls the test hospitals had a greater than one-third reduction in complications and achieved an almost 50% reduction in deaths (from 1.5% to 0.8%) (N=7,580) de Vries EN, et al. Effect of a Comprehensive Surgical Safety System on Patient Outcomes. N Engl J Med 2010; 363:1928-1937
Veterans Health Affairs Implemented a surgical team training program incorporating a modified version of a surgical checklist in the operating theatres of 74 facilities Experienced a mortality reduction of 18% Neily J, Mills PD, et al. Association Between Implementation of a Medical Team Training Program. JAMA. 2010 Oct 20;304(15):1693-700
Site C *p<0.05
JC/Standard of Practice WHO/SC Checklist SCIP
Homework Build an implementation team. Schedule a time and a venue for a meeting to take place after January 23rd. This meeting is where the implementation team will be able to talk to as many OR physicians and staff as possible about the checklist at your hospital.
