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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Am. J. Obstet. Gynecol. · Jul 2014
Maternal mortality in the United States: predictability and the impact of protocols on fatal postcesarean pulmonary embolism and hypertension-related intracranial hemorrhage.
The purpose of this study was to examine the efficacy of specific protocols that have been developed in response to a previous analysis of maternal deaths in a large hospital system. We also analyzed the theoretic impact of an ideal system of maternal triage and transport on maternal deaths and the relative performance of cause of death determination from chart review compared with a review of discharge coding data. ⋯ Disease-specific protocols are beneficial in the reduction of maternal death because of hypertensive disease and postoperative pulmonary embolism. From 2-6 women die annually in the United States because of cesarean delivery itself. A reduction in deaths from postpartum hemorrhage should be the priority for maternal death prevention efforts in coming years in the United States.
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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.