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Compliance with the WHO Surgical Safety Checklist: deviations and possible improvements.

Rydenfält, Christofer LU ; Johansson, Gerd LU ; Odenrick, Per LU ; Akerman, Kristina and Larsson, Per-Anders LU (2013) In International Journal for Quality in Health Care 25(2). p.182-187
Abstract
BACKGROUND: /st>Previous research suggests that the World Health Organization Surgical Safety Checklist time-out reduces communication failures and medical complications and supports development of better safety attitudes. Previous research also indicates that different values can affect the implementation of interventions. OBJECTIVE: /st>To investigate the actual usage of the checklist in practice and to catalogue deviations for the purpose of identifying improvements. DESIGN: /st>Twenty-four surgical procedures were video recorded. The time-out was analysed quantitatively assessing compliance with a predefined observational protocol based on the checklist and qualitatively to describe reasons for non-compliance. SETTING:... (More)
BACKGROUND: /st>Previous research suggests that the World Health Organization Surgical Safety Checklist time-out reduces communication failures and medical complications and supports development of better safety attitudes. Previous research also indicates that different values can affect the implementation of interventions. OBJECTIVE: /st>To investigate the actual usage of the checklist in practice and to catalogue deviations for the purpose of identifying improvements. DESIGN: /st>Twenty-four surgical procedures were video recorded. The time-out was analysed quantitatively assessing compliance with a predefined observational protocol based on the checklist and qualitatively to describe reasons for non-compliance. SETTING: /st>The operating unit of a Swedish county hospital. MAIN OUTCOME MEASURES: /st>Compliance with checklist items and the participation of different personnel groups. Activities were conducted during the time-out. RESULTS: /st>Highest compliance was associated with patient ID, type of procedure and antibiotics; the worst with site of incision, theatre nurse team reviews and imaging information. Team member introductions occurred in half of the operations. Surgeons and the anaesthesia team dominated the time-out. CONCLUSION: /st>The checklist is not always applied as intended. The components that facilitate communication are often neglected. The time-out does not appear to be conducted as a team effort. It is plausible that the personnel's conception of risk and the perceived importance of different checklist items are factors that influence checklist usage. To improve compliance and involve the whole team, the concept of risk and the perceived relevance of checklist items for all team members should be addressed. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
checklists, communication, patient safety, quality improvement, teamwork
in
International Journal for Quality in Health Care
volume
25
issue
2
pages
182 - 187
publisher
Oxford University Press
external identifiers
  • wos:000316966800011
  • pmid:23335056
  • scopus:84875771605
ISSN
1464-3677
DOI
10.1093/intqhc/mzt004
language
English
LU publication?
yes
id
a08491b4-8e1d-420e-91df-a1b49dd4c6e0 (old id 3438538)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23335056?dopt=Abstract
date added to LUP
2013-02-04 14:30:03
date last changed
2019-07-30 01:42:31
@article{a08491b4-8e1d-420e-91df-a1b49dd4c6e0,
  abstract     = {BACKGROUND: /st>Previous research suggests that the World Health Organization Surgical Safety Checklist time-out reduces communication failures and medical complications and supports development of better safety attitudes. Previous research also indicates that different values can affect the implementation of interventions. OBJECTIVE: /st>To investigate the actual usage of the checklist in practice and to catalogue deviations for the purpose of identifying improvements. DESIGN: /st>Twenty-four surgical procedures were video recorded. The time-out was analysed quantitatively assessing compliance with a predefined observational protocol based on the checklist and qualitatively to describe reasons for non-compliance. SETTING: /st>The operating unit of a Swedish county hospital. MAIN OUTCOME MEASURES: /st>Compliance with checklist items and the participation of different personnel groups. Activities were conducted during the time-out. RESULTS: /st>Highest compliance was associated with patient ID, type of procedure and antibiotics; the worst with site of incision, theatre nurse team reviews and imaging information. Team member introductions occurred in half of the operations. Surgeons and the anaesthesia team dominated the time-out. CONCLUSION: /st>The checklist is not always applied as intended. The components that facilitate communication are often neglected. The time-out does not appear to be conducted as a team effort. It is plausible that the personnel's conception of risk and the perceived importance of different checklist items are factors that influence checklist usage. To improve compliance and involve the whole team, the concept of risk and the perceived relevance of checklist items for all team members should be addressed.},
  author       = {Rydenfält, Christofer and Johansson, Gerd and Odenrick, Per and Akerman, Kristina and Larsson, Per-Anders},
  issn         = {1464-3677},
  keyword      = {checklists,communication,patient safety,quality improvement,teamwork},
  language     = {eng},
  number       = {2},
  pages        = {182--187},
  publisher    = {Oxford University Press},
  series       = {International Journal for Quality in Health Care},
  title        = {Compliance with the WHO Surgical Safety Checklist: deviations and possible improvements.},
  url          = {http://dx.doi.org/10.1093/intqhc/mzt004},
  volume       = {25},
  year         = {2013},
}