LR31 / Implementation of the Surgical Safety Checklist into operating rooms will reduce the post-operative mortality & morbidity, increase the OR teams ´awarness of patient related issues and improve the patient safety in various surgical departments

Slovakia




Type of Patient Safety Practice
Clinical Risk Management Practice (CRMP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Implementation of patient safety initiatives
Patient safety theme the SCP/clinical risk management practice is aimed at
The implementation of the Surgical Safety Checklist into operating rooms of the surgical departments will reduce the post-operative morbidity and mortality. The aim of this practice is the improvement of Patient safety and quality of delivered care.
Objective of the CRM practice
The objective of the Surgical safety checklist concentrates next to the patient safety and improved quality of care on surgical health care departments. The implementation of Surgical safety checklist has positive effects on reducing the mortality, morbidity and prevalence of adverse events. regarding these positive results the health care will be more cost effective and will lead towards saving money. However, it always needs the right implementation approach (with taking into consideration of specific national health system needs) to be more successful and effective. Therefore WHO is encouraging the health care leaders of member states for minor modification of the checklist.
Short description of the CRM practice, including any references for further information
Application of Surgical safety checklist in every day practice into operating rooms of various surgical departments is very important for the patients safety. Implementation of this effective tool will bring benefit for patient and for health care professional too. Application of Surgical safety checklist into operating rooms will reduce the mortality, morbidity, prevalence of adverse events on various surgical departments and will prevent the communication failures between surgeons, anaesthesiologists and other health care professionals too. The checklist increased OR teams´awarness of patient-related issues, the procedure and expected risks. [page 1208, 1]
Innovator of the SCP, country of origin
The WHO recommended the implementation of Surgical Safety Checklist some years before. Many countries in the world implemented the WHO Surgical Safety Checklist as effective tool for reducing the mortality, morbidity and prevalence of adverse events in practice.
Involved health care staff
Health care professionals from selected hospitals (Anaesthesiologists, Surgeons and Nurses) were involved from several hospitals.
Tested in which countries/health care systems, health care context(s) and/or clinical specialty/specialties, including references
The Surgical Safety Checklist was tested in various surgical departments of hospitals from several countries (Canada, India, Jordan, New Zeeland, Phillipines, Tanzania, England, USA, Thailand and Finland). In years 2007 – 2009 - 8 hospitals of 8 cities (Canada: Toronto, India: New Delhi, Jordan: Amman, New Zeeland: Auckland Phillipines: Manila, Tanzania: Ifakara, England: London USA : Seeatle implemented the WHO Surgical Czecklist in the Safe Surgery Safes Lives program - 4 university and teaching hospitals realised a pilot study of the implementation of WHO Surgical Checklist in Finland - 9 surgical departments realised a study of the implementation of WHO Surgical Safety Checklist ( among 4 340 patients) in Thailand [2] Nongyao Kasatpibal, Wilawan Senaratana, Jittasporn Chitreescheur (2009)
Summary of evidence for effectiveness, including references
Different abstracts & articles suggested that surgical patients morbidity and mortality could be reduced with use of Surgical Safety Checklist into operating rooms of various surgical departments. The WHO recently introduced the Surgical Safety Checklist as effective tool for global use, which was adapted from aviation industry. The WHO Surgical safety checklist was modified for national needs in several countries (with small modifiacation). Implementation of Surgical Safety Checklist will bring improvements in communication activities by involved health care professionals. Results of pilot study from Finland [1] shows that: - Patient’s identity was more often confirmed (A: 62.7% vs. 84.0%, S: 71.6% vs. 85.5%, CN: 81.6% vs. 94.2%, P < 0.001) and knowledge of names and roles among team members (A: 65.7% vs. 81.8%, S: 71.1% vs. 83.6%, CN: 87.7% vs. 93.2%, P < 0.01) improved with the checklist. [page 1208, 1 ] - Anaesthesiologists and surgeons discussed critical events preoperatively (A: 22.0% vs. 42.6%, S: 34.7% vs. 46.2%, P < 0.001) more frequently after the checklist. [page 1208, 1 ] - In addition, fewer communication failures (43 vs. 17, P < 0.05) were reported with checklist. [page 1208, 1 ] - The Surgical safety checklist increased OR teams’ awareness of patient-related issues, the procedure and expected risks. It also enhanced team communication and prevented communication failures. Our findings support use of the WHO checklist in various surgical fields [page 1206, 1] THE RESULTS OF Study [3]: A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population confirmed that : The rate of any complication at all sites dropped from 11,0% at baseline to 7,0% after introduction of the checklist [page 495, 3 ] The overall rates of surgical site-infection and unplanned reoperation also declined significantly. . [page 495, 3 ] The rate of death was reduced from 0,9% before checklist introduction to 0,6% afterward at high inbcome sites. (P=0,18) [page 495. 3 ]
Summary of evidence for transferability (transferability across health care systems or health care contexts or clinical specialties), including references
There is evidence in articles, that Surgical Safety Checklist is transferable with minor ammendments into operating rooms of various surgical departments in different countries. However, some articles pointed out that the WHO Surgical Safety Checklist were modified for national use in several countries. Some minor amendments were made in respect of medical information prior to induction of anaesthesia and the diagnosis and the procedure codes [page 1207 and see Appendix 1 page 1214, 1]
Summary of available information on feasibility, including references
The concept of Surgical Safety Checklist is very feasible. The results of several studies and available information have been confirmed that Surgical Checklist can be feasible in every day practice and can be successfully implemented into operating rooms of various surgical departments of hospitals. The use of Surgical Safety Checklist in every day practice is mandatory in some developed countries (England and Canada.) [4] The UK National Health Service (NHS) declared the completion of the checklist mandatory less than one month following the article's publication [4] in Canada public reporting of checklist completion was made mandatory in July 2010 (Ministry of Health and Long-Term Care [MOHLTC] 2009) and became an Accreditation Canada required organizational practice in January 2011 (Accreditation Canada n.d.) [4]
Existing implementation tools, including references
Existing implementation tools are as followed: The WHO launched the Surgical Safety Checklist in Europe in 2009. The Surgical Safety Checklist was translated into several languages and modified for national use in collaboration with national health authorities. WHO encourages local modifications of the checklist, some minor amendments were made in respect of medical information.
Potential for/description of patient involvement in the CRM practice, including references
Description of active patient involvement were found in the abstracts: : - The patient has verified his or her identity, the surgical sidte nad procedure, and consent . [page 492 Table 1, 3]
Bibliography (for each reference: author(s), year, title, journal/internet link, page(s))
[1] Takala, Pauniaho, Helmio (2011): Evidence: A pilot study of thew implementation of WHO Surgical Checklist in Finland: improvements in activities and communication. The Acta Anaesthesiologica Scandinavica Foundation . [2] Nongyao Kasatpibal, Wilawan Senaratana, Jittasporn Chitreescheur (2009): Implementatation of the WHO Surgical Safety Checklist at a University Hospital in Thailand [3] Haynes, Weiser, Berry, Lipsitz, Breizat.(2010): A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population The New England Journal of Medicine [4] Surgical Safety Checklist: Improved Patient Safety through Effective Teamwork Healthcare Quaterly Longwood.com (Chris W. Hayes, MD, MSc, MEd, FRCPC, is assistant professor, Department of Medicine, University of Toronto, medical officer of the Canadian Patient Safety Institute and medical director of Quality and Patient Safety, St. Michael's Hospital, Toronto)
Reviewer
MUDr. Eugen Nagy
Organisation
Health Care Surveillance Authority, Slovakia
Any additional information on the CRM (e.g. implementation barriers and drivers)
There is no specified text here
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