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970 / Optimising the implementation of the Safe Surgical Checklist

ITALY
Classification of the PSP
Type of Patient Safety Practice Potentially Safe
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Surgical / Invasive procedures
Other There is no specified text here
Topic of the reported practice
Patient safety system
Aim and the benefit of the Patient Safety Practice
 
Thanks to incident reporting in the year 2005/2006 some critical issues regarding the pathway of the surgical patient (from the unit to the operating room and viceversa) were identified. Therefore we started a re-organization aimed at improving safety of the surgical patient.
Description of the Patient Safety Practice
 
It was decided to implement the checklist recommended by the Italian Ministry of Health based upon the one developed by the WHO. For 2012 a mandatory training course was planned for the health professionals involved. The course was structured as follows: a first training day for the Heads of the services who were trained by Quality Accreditation and Risk Management Service and 7 other training days where trained staff taught the remaining professionals. At the end of the course (December 2012) the new check-list was implemented and its use is being monitored. A working group revised the existing check-list to make a tool with the purpose of maintaining traceability of the perioperative care pathway. The audit done in June 2013 which has taken in consideration the data of the first 5 months of the year has underlined the need to strengthen and make more relevant the nurse role as the Check-list Coordinator. For this purpose, to solve any critical situations, it has been decided to strengthen the role of the anesthetist who is present in the Operating Theatre. Following the audit done and in consideration of the changes on the wrong interpretation shared and introduced a further audit has been planned for December 2013. Some results: 100% of medical staff attended the training courses The check-List was found in 96% of medical records even if the compilation resulted fragmentary. The checklist appears to be incomplete in 48% of the analyzed documents (Sign.in incomplete in 50% of records and the sign out in 20.4%). The incompleteness of the sign-in is a common feature for most of the evaluated units except for gynecology and obstetrics for which the check list resulted more incomplete in the sign-out.
Attachment of relevant written information and/or photos, as appropriate
There is no specified text here
There is no specified text here
There is no specified text here
There is no specified text here
Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, partly
Level of implementation of reported practice
Institution level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Yes
A measurement after full implementation of the reported practice was obtained
No
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
Both/mixed (qualitative and quantitative)
Enclosure of a reference or attachment in case of published evaluation's results
There is no specified text here
There is no specified text here
Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
No
Specification of implementation in another health care setting(s)
There is no specified text here
Successful implementation's level  of this Patient Safety Practice across settings
There is no specified text here
Involved health care staff
 
Physicians
Nurses
Clinical manager
Quality manager
Risk manager
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
No
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
There is no specified text here
Point of time in which service user or their reprasentatives' involvement takes place
There is no specified text here
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
There is no specified text here
Short description of the service users' level of involvement
There is no specified text here
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
Yes
List of sources where public information is accessible
http://buonepratiche.agenas.it/practicesedit.aspx?id=4391
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
No
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
Yes
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
Lack of sharing of progress information among involved staff
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
There is no specified text here
Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
There is no specified text here
Contact information
 
Name: Cristina Giordano
Country: ITALY
Organisation: ASL4 Chiavarese
E-mail: cgiordano@asl4.liguria.it
Phone: +39 0185 329524
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