• Surgery · May 2012

    Novel use of electronic whiteboard in the operating room increases surgical team compliance with pre-incision safety practices.

    • Rajshri Mainthia, Timothy Lockney, Alexandr Zotov, Daniel J France, Marc Bennett, Paul J St Jacques, William Furman, Stephanie Randa, Nancye Feistritzer, Roland Eavey, Susie Leming-Lee, and Shilo Anders.
    • Vanderbilt University School of Medicine, Nashville, TN, USA. rajshri.mainthia@vanderbilt.edu
    • Surgery. 2012 May 1;151(5):660-6.

    BackgroundDespite evidence that use of a checklist during the pre-incision time out improves patient morbidity and mortality, compliance with performing the required elements of the checklist has been low. In an effort to improve compliance, a standardized time out interactive Electronic Checklist System [iECS] was implemented in all hospital operating room (OR) suites at 1 institution. The purpose of this 12-month prospective observational study was to assess whether an iECS in the OR improves and sustains improved surgical team compliance with the pre-incision time out.MethodsDirect observational analyses of preprocedural time outs were performed on 80 cases 1 month before, and 1 and 9 months after implementation of the iECS, for a total of 240 observed cases. Three observers, who achieved high interrater reliability (kappa = 0.83), recorded a compliance score (yes, 1; no, 0) on each element of the time out. An element was scored as compliant if it was clearly verbalized by the surgical team.ResultsPre-intervention observations indicated that surgical staff verbally communicated the core elements of the time out procedure 49.7 ± 12.9% of the time. After implementation of the iECS, direct observation of 80 surgical cases at 1 and 9 months indicated that surgical staff verbally communicated the core elements of the time out procedure 81.6 ± 11.4% and 85.8 ± 6.8% of the time, respectively, resulting in a statistically significant (P < .0001) increase in time out procedural compliance.ConclusionImplementation of a standardized, iECS can dramatically increase compliance with preprocedural time outs in the OR, an important and necessary step in improving patient outcomes and reducing preventable complications and deaths.Copyright © 2012 Mosby, Inc. All rights reserved.

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