Rationale, Aims, And Objectives: The WHO Surgical Safety Checklist is a communication tool designed to improve surgical safety processes and enhance teamwork. It has been widely adopted since its introduction over ten years ago. As surgical safety needs evolve, organizations should periodically review and update their checklists. A holistic evaluation of the checklist in the context of an organization is the first step to making informed updates. In this article, we describe a comprehensive but feasible strategy for checklist evaluation which we developed and implemented as part of a surgical safety initiative in a high-performing center.
Methods: A three-part evaluation plan was developed and carried out by a multidisciplinary team. The evaluation included assessment of 1. Quality of care through a review of surgical safety events; 2. Safety culture through a validated survey and informal feedback; and 3. Checklist performance through direct observations and a staff survey. To prepare for re-implementation the current institutional checklist was critically evaluated and a context assessment survey was administered to surgical staff.
Results: The evaluation revealed challenges in communication and teamwork, with surgical staff often perceived to be working in silos. The quality of care assessment indicated room for improvement in safety processes. Deficiencies in the safety culture measures of communication and feedback shed light on an overall lack of engagement with the checklist. Checklist performance demonstrated good adherence to the items on the checklist but limited engagement by the surgical team and minimal communication between subteams. These findings informed our revisions to the checklist and its implementation processes.
Conclusions: We developed and implemented a comprehensive, scalable approach to checklist evaluation which directly informed improvements to the checklist that were tailored to the organization's current context. Organizations can apply this framework to breathe new life into their checklist and transform their safety culture.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1111/jep.13778 | DOI Listing |
Zhonghua Wei Chang Wai Ke Za Zhi
December 2024
Department of Gastroenterology, Dongguan Children's Hospital Affiliated to Guangdong Medical University, Dongguan Eighth People's Hospital, Dongguan523000, China.
To evaluate the clinical efficacy of modified endoscopic mucosal resection (EMR) in the management of early gastrointestinal lesions. Upon endoscopic identification of the lesion, normal saline is injected into the submucosa to establish a fluid cushion, which elevates the lesion's mucosa. Methylene blue may also be applied to improve visualization of the relationship between the submucosa and muscular layer.
View Article and Find Full Text PDFAnn Surg Oncol
December 2024
Division of Breast Surgery, Department of Surgery, Linkou Chang Gung Memorial Hospital, Taoyüan, Taiwan, R.O.C..
Background: We investigated the perioperative outcome and oncologic safety of performing nipple-sparing mastectomy (NSM) through a single axillary incision (NSM-SAI) compared with performing NSM through a conventional incision (NSM-C).
Methods: We retrospectively reviewed 725 patients who underwent NSM for breast cancer between January 2010 and December 2023; 333 patients who underwent NSM with immediate reconstruction (IR) were enrolled. Surgical outcomes and oncologic outcomes of NSM-C (n = 184), NSM performed through SAI with a freehand approach (NSM-SAI-F; n = 92), and with an endoscopic approach (NSM-SAI-E; n = 57) were demonstrated.
Trials
December 2024
Liver Transplantation Center, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center of Biotherapy, Chengdu, 610041, China.
Background: Indocyanine green (ICG) is a near-infrared fluorescent dye widely used for intraoperative navigation during liver surgeries because of its non-radioactive nature, high safety, and minimal impact on liver function. However, variability in its dosage and concentration and its low imaging success rates have limited its widespread application. To address these issues, we developed a novel ICG-human serum albumin (ICG-HSA) complex to enhance fluorescence visualization during laparoscopic anatomical liver resection.
View Article and Find Full Text PDFZhonghua Wei Chang Wai Ke Za Zhi
December 2024
Department of General Surgery, General Hospital of Eastern Theater Command, PLA, Nanjing 210002, China.
To evaluate the safety, effectiveness, and long-term efficacy of the Jinling procedure for management of refractory mixed constipation. We prospectively collected clinical data of patients with refractory mixed constipation treated by the Jinling procedure in the Institute of General Surgery of our hospital from January 2007 to August 2023. Perioperative complications, effectiveness within 1 year of surgery (as assessed by the Wexner constipation score, gastrointestinal quality of life index, frequency of spontaneous defecation, rate of satisfactory defecation, body composition, serological indicators, defecography, anorectal manometry) and 10 years after surgery (as assessed by the Wexner constipation score, patient assessment of constipation symptom, SF-36 quality of life score, and questionnaire concerning satisfaction with defecation).
View Article and Find Full Text PDFZhonghua Wei Chang Wai Ke Za Zhi
December 2024
Department of General Surgery, General Hospital of Eastern Theater Command, PLA, Nanjing 210002, China.
When chronic constipation develops to the stage of intractable constipation, the symptoms of constipation in patients are severe and persistent, and drug treatment is often ineffective, so surgical treatment is often considered. The clinical manifestations of patients with intractable constipation are variable, and the underlying pathophysiological changes involve various abnormal and dysfunctional anatomical structure of colorectal and pelvic floor, which are different. For the surgical treatment of intractable constipation, accurate preoperative classification diagnosis is very important, and it is necessary to formulate an exact and effective surgical plan to avoid untargeted empirical treatment.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!