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Surgical Safety Checklist

Patient safety remains the most important priority for Quinte Health Care and this includes ensuring a safe experience for patients who undergo surgery here. One tool used to ensure a positive patient experience is a surgical safety checklist. Beginning July 30, 2010, all Ontario hospitals with operating rooms are required to publicly report on their surgical safety checklist compliance. This indicator is the most recent addition to the Ontario Government's public reporting regime.  QHC's compliance can be viewed, along with all Ontario hospitals, on the Health Quality Ontario website: http://www.hqontario.ca/System-Performance/Hospital-Care-Sector-Performance

Compliance is calculated by the number of times all three phases of the surgical safety checklist were completed, as a percentage of the total number of surgeries performed. The surgical safety checklist is considered "performed" when the surgical team members have implemented and/or addressed all of the necessary tasks and items in each of the three phases: Briefing; Time Out; and Debriefing.

What is a surgical safety checklist?

A surgical safety checklist is a patient safety communication tool that is used by a team of operating room professionals (nurses, surgeons, anesthesiologists, and others) to discuss important details about each surgical case.

In many ways, the surgical checklist is similar to an airline pilot's checklist used just before take-off. It is a final check prior to surgery used to make sure everyone knows the important medical information they need to know about the patient, all equipment is available and in working order, and everyone is ready to proceed.

What information is included in a surgical safety checklist?

Some examples of items contained in the checklist:

The Briefing Phase:

  • Verify with patient name and procedure to be done
  • Allergy check
  • Medications check
  • Operation site, side and procedure
  • Lab tests, x-rays

The "Time Out" Phase:

  • Patient position
  • Operation site and side and procedure
  • Antibiotics check

The Debriefing Phase:

  • Surgeon reviews important items
  • Anesthesiologist reviews important items
  • Nurse reviews correct counts

Why isn't QHC's compliance at 100%?

The surgical teams at QHC have always used the information contained in the checklist to ensure that our patient care is safe. The Surgical Safety Checklist formalizes what we have already been doing to ensure that our team communication is seamless, thereby further improving the safety of the care we provide.

With the new three-phase approach to the surgical safety checklist, many hospitals and surgical teams need to change the way they work to get all three phases completed. This takes time, as work flow varies in different surgical departments, and different settings. In some cases, physicians have had to completely reorganize their day in order to attend all three phases, and this is not always easy due to their multiple competing priorities.

The SSCL compliance indicator is also a process measure, measuring the degree to which all three phases of the checklist were performed correctly and appropriately for each surgical patient. If even one part of one phase of the checklist is not conducted as prescribed, the checklist is marked as not completed.

Will a surgical safety checklist be used on me?

If you are undergoing surgery at QHC you can expect the surgical safety checklist to be performed during the procedure.

The surgical safety checklist is performed at three separate stages during surgery: 1) before you are put to sleep, 2) just before the incision, and 3) before you leave the operating room.

You will meet several members of the team including the admitting nurse, the surgeon, the anaesthesiologist, and the operating room nurse. You will be repeatedly asked a number of questions related to your medical information and your surgery. These questions will include asking for your name, what procedure you are having done, and the location of the surgery as well as things like allergies. The surgeon will also mark your operative site when appropriate. Remember all of these activities are being done to ensure your safety, comfort and well-being.

If you have any questions or concerns please talk to any member of the surgical team or discuss your concerns during the pre-admission screening process.

For more information on the surgical safety checklist visit www.safesurgerysaveslives.ca or www.cpsi.ca.