Articles: checklist.
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The effectiveness of the World Health Organization's (WHO) surgical safety checklist (SSCL) in decreasing mortality and morbidity of surgical procedures was firstly suggested in 2009; the checklist is now strongly recommended internationally for adoption as a highly effective yet economically simple intervention. However, since 2009 several published studies have reported inconsistent results, besides many issues concerning local implementation. Drawing on the recently published experience carried out in Ontario, a concise overview of the current debate is presented, with some comments on implications for the national healthcare system in Italy. More generally, the need to include the implementation of the SSCL in a larger effort addressing safety in surgery is pointed out.
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Surgical safety checklists aim to improve patient safety by prompting the attention of the surgical team towards critical steps during the operation. The checklist's items are aimed to improve compliance with proven interventions, and to facilitate multidisciplinary communication and teamwork. Based on the current literature, corroborated by systematic reviews and meta-analysis, surgical safety checklists have a positive impact on communication and reduce postoperative complications including mortality. ⋯ Several determinants leading to behaviour were checklists are checked but not properly executed have been highlighted. As surgical safety checklists are in essence complex sociological interventions, they must be implemented accordingly. Key factors for the implementation of these checklists have been suggested in the literature, although, the most profound way of implementation remains unclear.
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Approximately 2,700 patients are harmed by wrong-site surgery each year. The World Health Organization created the surgical safety checklist to reduce the incidence of wrong-site surgery. ⋯ Analysis of results indicated the effectiveness of the surgical checklist in reducing the incidence of wrong-site surgeries and other medical errors; however, checklists alone will not prevent all errors. Successful implementation requires perioperative stakeholders to understand the nature of errors, recognize the complex dynamic between systems and individuals, and create a just culture that encourages a shared vision of patient safety.
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Multicenter Study
[A surgical safety checklist implementation: experience of a start-up phase of a collaborative project in hospitals of Catalonia, Spain].
Surgical patient safety is a priority in the national and international quality healthcare improvement strategies. The objective of the study was to implement a collaborative intervention with multiple components and to evaluate the impact of the patient surgical safety checklist (SSC) application. This is a prospective, longitudinal multicenter study with a 7-month follow-up period in 2009 based on a collaborative intervention for the implementation of a 24 item-SSC distributed in 3 different stages (sign in, time out, sign out) for its application to the surgical patient. ⋯ The SSC was successfully implemented to 48% of the surgeries performed to the participating hospitals. The global compliance with the SSC was elevated and the intervention trend was stable during the evaluation period. Strategies were identified to allow of a higher number of surgeries with application of the SSC and more professional involvement in measures compliance such as surgical site marking.