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Achieving flying colours in surgical safety: audit of World Health Organization ‘Surgical Safety Checklist’ compliance

Published online by Cambridge University Press:  15 August 2012

Y Sheena ,
J M Fishman ,
C Nortcliff ,
T Mawby ,
A F Jefferis  and
N R Bleach
Y Sheena
Affiliation:
Department of Otolaryngology, Wexham Park Hospital, Slough, UK
J M Fishman*
Affiliation:
Department of Otolaryngology, Wexham Park Hospital, Slough, UK Institute of Child Health, University College London, UK
C Nortcliff
Affiliation:
Department of Otolaryngology, Wexham Park Hospital, Slough, UK
T Mawby
Affiliation:
Department of Otolaryngology, Wexham Park Hospital, Slough, UK
A F Jefferis
Affiliation:
Oxford Deanery, Headington, UK
N R Bleach
Affiliation:
Department of Otolaryngology, Wexham Park Hospital, Slough, UK
*
Address for correspondence: Mr Jonathan M Fishman, Wexham Park Hospital, Slough SL2 4HL, UK E-mail: j.fishman@ucl.ac.uk
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Abstract

Objective:

The World Health Organization ‘Surgical Safety Checklist’ has been adopted by UK surgical units following National Patient Safety Agency guidance. Our aim was to assess compliance with our local version of this Checklist.

Methods:

Otolaryngology trainee doctors prospectively assessed compliance with the local Checklist over a six-week period. A staff educational intervention was implemented and the audit was repeated 12 months later.

Results:

A total of 72 cases were assessed. The initial audit found that: 44 per cent of procedures were undocumented at ‘Sign in’; ‘Time out’ was inappropriately interrupted in 39 per cent of cases; the procedure started before Checklist completion in 33 per cent of cases; and the ‘Sign out’ was not read out in 94 per cent of cases and was not fully documented in 42 per cent of cases. Following education, re-audit indicated that overall compliance had improved from 63.7 per cent (±8.9 per cent standard error of the mean) to 90.4 per cent (±2.7 per cent standard error of the mean).

Conclusion:

Our completed audit cycle demonstrated a significant improvement in Checklist compliance following educational intervention. We discuss barriers to compliance, as well as strategies for quality improvement, and we call for other surgeons to similarly publish their Checklist experience and assess its impact on surgical outcomes.

Keywords

OtolaryngologySafetyAuditWorld Health OrganizationChecklistSurgical ProceduresOperative
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 10 , October 2012 , pp. 1049 - 1055
Copyright
Copyright © JLO (1984) Limited 2012

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