MISSOURI SAFE SURGERY SAVES LIVES DASH April 24 and 29, 2009 Missouri Hospital Association Missouri Center for Patient Safety HOSPITALS’ EXPERIENCE Citizens Memorial Hospital – Linda Harris Community Hospital – Fairfax – Rhonda Evans Others? Freeman Health System – Mona Caylor
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April 24 and 29, 2009
Missouri Hospital Association
Missouri Center for Patient Safety
AThe two are not in conflict but use of the WHO checklist does not ensure compliance with UP. TJC is reviewing the UP to determine if refinements are needed.
The WHO checklist does not include the following: verification of required implant and devises, properly labeled diagnostic and radiology results, correct position.
You don’t have to document completion of the WHO checklist but you do the UP.
ALook at modified checklists on the SafeSurgery web site and the guidelines for modifying on the IHI Web site.
AIdeally the entire team, but at a minimum the anesthesia provider and the scrub or circulating nurse need to be present. Not an expectation that the surgeon be there but it would be ideal. The more staff present, the better the process will be.
AGenerally patients are comforted by the process. There should be appropriate language developed.
ALook at what you already measure: SSIs, mortality rate, retained objects, compliance with SCIP measures, AHRQ PSI indicators.
AIdeally it should be the surgeon but the circulating nurse is most likely to be the one to do it. You don’t have to actually check it off; it is just a safety tool not a documentation tool. Don’t change your current documentation process.
AThe checklist is not designed to be totally comprehensive. It is designed for the greatest risk factors. Reviewing meds for risk of bleeding etc. is not widely applicable. If you add too much, the list becomes unruly.
AHave a surgeon talk to the surgeons using a short video clip and presentation about 10 minutes in length.