Seven Tips to Turbo Charge Your Surgical Safety Checklists
Collierville, Tennessee (PRWEB) July 09, 2013 -- Over 3000 hospitals around the world have registered with the World Health Organization to implement the use of a pre-procedure surgical checklist. This is not surprising given the widely publicized data proving the use of the 19-item WHO Safe Surgery Checklist reduces the complications and mortality associated with a variety of surgical procedures by more than 30 percent. http://www.who.int/en/
With documented results like these, more than 300 professional societies, health organizations, ministries, and Non-Governmental Organizations have endorsed the concept of using a presurgery checklist. However, many health care organizations have found it easier to introduce the idea, rather than implement the actual daily practice of using a checklist. Hospitals and surgical centers everywhere have struggled with successful implementation of a pre-procedure safety checklist.
LifeWings has helped over 100 organizations around the world create and successfully implement checklists. LifeWings offers seven sure-fire tips to boost the success rate of the hospital checklist implementation process.
1) Ensure it is user-built and maintained.
The most important phrase on the current WHO Surgical Safety Checklist is located on the bottom of the page: “This checklist is not intended to be comprehensive. Additions and modifications to fit local practice are encouraged.” Effective checklists borrow heavily from the “Kaizen” methodology of the Toyota Manufacturing Process. In Kaizen, the people who actually do the work are best suited and most responsible for creating the standard for how the work is accomplished.
2) Keep it short.
Not everything has to be on a checklist. Checklists are used to verify only the critical items of a procedure. Critical items are those that if not done correctly will cause harm to patients or caregivers before that error can be stopped. With checklists, shorter is better.
3) Don’t confuse your checklist with an audit tool.
Great checklists are not designed to use as an audit tool. Checklists are not about creating a paper trail, they’re a critical job aid to help the team (not the individual) cross check and verify, with two or more independent “sets of eyeballs,” that critical items haven’t been missed. This cross check by multiple team members creates the needed engagement and mindfulness by the surgical team during the checklist process, and is much more valuable to overall safety than having tick marks in the appropriate boxes.
4) Include speaking parts for the team.
Effective checklists will trigger a scripted conversation and verbal cross check of critical steps in the procedure. The more speaking parts different members of the team have, the more mindfulness and involvement you’ll have in the checklist process. The reason is simple - if a team member knows they have a speaking part, they must pay attention to the checklist flow and be ready with their verbal response. The timely public declaration, in front of a team of peers, that the item you are responsible for has been checked, and is as it should be, creates a sense of responsibility and mindfulness in each member of the team that has a speaking role in the checklist.
5) Use standardized and scripted language.
Speaking parts only work if the exact language and words that should be used for each item on the checklist are crystal clear and standardized - down to the exact word or phraseology that must be used. In other words, checklist dialogue should be scripted.
6) Design your checklist as a “Read and Verify” tool.
There are essentially two types of checklists in use by High Reliability Organizations (HROs) - Read and Do and Read and Verify. In a Read and Do checklist, the operator reads the item on the checklist and then does that step immediately after reading it. This cumbersome approach to checklists will cause most surgical teams to resist using a pre-procedure checklist. Overcome this resistance by teaching your teams to use a Read and Verify checklist system. With this method the team accomplishes critical and routine actions from working memory. Used this way, it takes only seconds for the team to cross check and verify that nothing critical has been missed. The speed and efficiency of this method will greatly reduce the resistance you experience with implementing a checklist
7) Make it surgeon led.
In HROs such as commercial aviation, checklists are “owned” by the team leader – the captain of the crew. The captain uses the checklist to manage workflow and team performance. Checklists are one of the primary tools for supervising the team. Airline captains understand the value of checklists in creating teamwork, fostering communication, and setting expectations that team members will be vigilant and provide safety monitoring. In the case of the OR team,checklists are owned by the physician performing the surgery. Surgeons, just like airline captains, have a vested interest in ensuring checklists are used effectively and completely.
No matter where you are on your checklist journey, these seven tips will improve the speed of your implementation process and help you reap the patient safety rewards of a well-designed checklist system. http://www.youtube.com/watch?v=LV_M0zIuan8
LifeWings Partners creates documented, sustainable improvements in cost reduction, efficiency, reliability, safety, and quality by combining the best of Lean and TeamSTEPPS. LifeWings has improved the financial bottom line and patient safety record of over 140 hospitals worldwide. The LifeWings coaching cadre of pilots, astronauts, physicians, nurses and Toyota-trained Lean experts train more than 13,000 administrators, physicians and staff per year. Measurable results are guaranteed in all LifeWings’ initiatives. Documented return on investment typically exceeds 300%. To find out more, please visit http://www.saferpatients.com or https://www.facebook.com/LifeWingsSaferPatients.
Stephen Harden, Lifewings Partners, LLC, http://www.saferpatients.com, 901-457-7505, [email protected]
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