Home E-Weekly June 17, 2014

How a City Standardized Its Pre-Surgical Safety Checklists

Published: June 16, 2014

Hospitals and surgery centers in Wichita, Kan., collaborated with area surgeons to develop a standardized pre-op safety checklist as part of a community-wide effort to protect patients from harm.

The agreed-upon form has been used at participating facilities since the official launch of the program in March. "We're all competitors, and we're still competing for services, but we decided to collaborate on patient safety issues," says Ruth Hommertzheim, MSN, BSN, RN, APRN, CNS-BC, CNOR, clinical process reliability coordinator at Via Christi Hospitals, the health system where the idea was born.

Ms. Hommertzheim says Via Christi needed to improve the on-time delivery of pre-op antibiotics as mandated by the Surgical Care Improvement Project, and figured other facilities in the area were also having issues with overly complicated safety checklists that staff didn't use properly.

In addition, the city's surgeons would routinely perform procedures at 3 different facilities where time outs were conducted differently each time. The essential safety elements were included, and surgical teams regularly completed time outs, but all too often they went through the motions, mindlessly checking boxes and performing the pre-op pauses at irregular times.

No more. At all facilities, there's a hard stop for the reading of the standardized checklist before the incision is made. Surgeons, anesthesia providers and members of the surgical team have defined roles that demand active participation.

"Physicians love the consistency, and now everyone knows their role," says Ms. Hommertzheim. "Behaviors have changed."

Daniel Cook

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