 |
Patient Safety Checklist
Goal:
Recognizing that surgical safety is a major priority for
health care safety and quality improvement and New Hampshire
hospitals and ambulatory surgery centers are committed to
implementing evidence based practice, every hospital and ASC
in New Hampshire will adopt and post a safety checklist in
all procedure areas where an incision is made or anesthesia
is administered.
This Safety Checklist differs from the commonly used
‘time-out’ process which confirms site, patient and
procedure, in that it is designed to improve communication
among team members and promote the consistency of care being
delivered. The Safety Checklist involves oral communication
by teams as to the completion of essential steps for
ensuring safe care at three critical junctures: prior to
anesthesia, prior to incision or procedure, and before
leaving the operating room or procedure area.
Background:
In January 2007, the World Health Organization (WHO)
began a two year process to identify minimum standards of
surgical care to address important safety issues such as
inadequate anesthetic safety practices, avoidable surgical
infection, and poor team communication. They sought
international input from surgeons, anesthesiologists,
nurses, infectious disease specialists, epidemiologists,
biomedical engineers, and quality improvement experts to
create a surgical safety checklist which encompassed
essential standards of surgical care and which was designed
to be simple, widely applicable, and to address common and
potentially disastrous lapses in practice. To implement the
checklist, surgical teams introduced a formal pause in care
prior to induction of anesthesia, prior to incision, and
just before closure of the incision. Use of the checklist
involved both changes in processes and changes in the
behavior of individual teams.
Since that time, the WHO checklist has been validated in
eight pilot sites in diverse global settings. Results
published in the January 29, 2009 issue of the New England
Journal of Medicine showed that facilities that implemented
the checklist saw postoperative complication rates fall, on
average, by 36% and death rates fell by a similar amount.
Only two of the safety measures in the checklist entail the
commitment of significant resources: use of pulse oximetry
and use of prophylactic antibiotics, both of which are
already common practice in our state.
Based on a consensus of the Commission at its January 23rd
meeting, members agreed to adopt and post a safety checklist
in all procedure areas where an incision is made or
anesthesia is administered. If institutions have not already
adopted a tool and process, the Commission recommended using
the WHO tool as a starting point for discussion with your
clinical staff. If organizations have an established system,
the Commission requested that they review their tool to
insure that all key elements for the 3 checkpoints are
covered in the process.
World Health Organization (WHO) Checklist
Patient Safety Checklist Audit Process Guidelines and Tool |
