Patient participation in checklist is win-win
Patients feel safer - and likely are safer - when they receive a surgical safety checklist and request that their healthcare providers use it, suggests a pilot study being presented at the American Society of Anesthesiologists' Practice Management 2014 meeting.
Use of the World Health Organization (WHO) Surgical Safety Checklist (SSC) has been reported to reduce complication rates. Seeking ways to boost compliance of the SSC, researchers at Tulane University Hospital and Clinic decided to involve patients. Patients were informed of the list and asked their providers to be sure to follow it.
"The checklist is only beneficial when it is used, and we found that involving patients helps ensure that surgical teams complied with it," said Seth Christian, MD, MBA, director of quality for the Department of Anesthesiology at the Tulane University Hospital and Clinic, New Orleans. "Empowering patients to participate in their own care creates a culture of safety and makes them feel safer - and rightly so."
The study compared compliance of the SSC in 61 patients who were not informed about the list and 43 patients who were told about the list and given a copy. The copy included a place for providers to sign agreeing they would follow it. When patients were informed, compliance was higher for all 26 checklist items. The difference was statistically significant for 19 of the 26 items. For example, allergies were confirmed in 95% of the informed patient group vs. 69% of the uninformed group. The surgical site was confirmed in 74% of informed patients vs. 54% of uninformed patients. Sponge and instrument counts were formally reviewed in 87% of informed patients vs. 19% of uninformed patients. Actual performance of each task on the list was confirmed by students who secretly were auditing its use while observing the surgeries.
While only 35% of informed patients had heard of surgical safety checklists, all said the SSC made them feel more comfortable going into their surgeries.
Although Tulane uses a slightly modified version of the WHO SSC to include the addition of a section on preprocedure check-in, researchers focused the study on compliance of the items on the WHO's version of the list. n
