South Carolina ORs adopt surgery checklist
Harvard comes to the Palmetto state
South Carolina hospitals are moving to the leading edge of the patient safety movement, collaborating with The Joint Commission on multiple projects and adopting a highly touted surgical safety checklist in every operating room in the state.
The 2015 Surgical Safety project is the brain child of author and surgeon, Atul Gawande, MD, who developed the checklist along with colleagues at the Harvard University School of Public Health. All 61 acute care hospitals in South Carolina have pledged to implement the checklist as a routine component of surgical care, according to the South Carolina Hospital Association. (See checklist, p 3.)
Project leaders estimate that even if the effort is only minimally successful, at least 500 lives will be saved annually along with $28 million in health care costs.
Gawande led the World Health Organization’s Safe Surgery Saves Lives Initiative, which resulted in development of a surgical checklist that has reduced surgery-related complications by more than one-third. Gawande documented his experience creating and testing the WHO Surgical Safety Checklist in his book "The Checklist Manifesto."
Key checkpoints on the surgical list include reviewing patient information and verifying the surgical site before the induction of anesthesia. The anesthesiologist shares patient-specific information with the rest of the surgical team, which goes down a checklist of patient risks and underscores that any team member can call for a "time out" if a break in protocol is observed.
The surgeon reiterates this safety factor, asking, "Does anybody have any concerns? If you see something that concerns you during this case, please speak up." In a debriefing following the procedure the surgical team discusses key concerns for patient recovery and management, with discussions centering on the question: "What could have been done to make this case safer or more efficient?"
Editor’s note: for more on the South Carolina surgical checklist program go tohttp://www.safesurgery2015.org/