In the Literature: Surgical checklist improves teamwork and compliance with best practice

This project was selected from among many reported in the peer reviewed literature. For a list of more articles on quality improvement, visit our resource bibliography.

ARTICLE CITATION

Kearns, R. J., Uppal, V., Bonner, J., Robertson, J., Daniel, M., & McGrady, E. M. (2011). The introduction of a surgical safety checklist in a tertiary referral obstetric centre. BMJ Quality & Safety, doi:10.1136/bmjqs.2010.050179 (abstract)

NAME OF AGENCY/ORGANIZATION/INSTITUTION

Glasgow Royal Infirmary, a tertiary referral obstetric center in the U.K. with approximately 6400 deliveries per year

PROJECT AIMS AND GOALS

To evaluate the introduction of a surgical safety checklist in a busy obstetric tertiary referral center by assessing staff attitudes, checklist compliance and patient experience.

APPROACH AND ACTIVITIES

For all scheduled cesarean deliveries, the hospital introduced a preoperative checklist to verify patient identity, indication for caesarean section, allergies, and presence of neonatology staff and a postoperative check to verify analgesia, oxytocic prescription, antibiotics, thromboprophylaxis and skin contact between mother and baby. Researchers examined staff attitudes before and after introduction of the checklists, checklist compliance, and whether patients experienced anxiety or were reassured by the process.

RESULTS

The proportion of staff who felt familiar with others in the operating room increased among both non-medical (nursing/midwifery) staff (75% vs. 50% before the checklist was introduced) and medical staff (31% vs. 4%). The majority of both medical staff and non-medical staff believed that the checklist was useful in elective cases and that communication had improved as a result of the checklist, although about 30% felt that a checklist would be inconvenient in emergency cases. Compliance with the checklist increased between 3 and 12 months after it was introduced. The vast majority (94%) of women were aware that a checklist safety procedure had occurred and of those who were aware, the vast majority (93%) found it reassuring rather than worrying.

BLUEPRINT AREA(S) ADDRESSED

STRATEGIES USED

Filed in Blueprint, Care coordination, Clinical practice guideline/policy change, Improved liability system, Team building on Wed., Aug 10, 2011

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