The safe surgery checklist guide: From source tools to implementation

During an Oct. 9 webinar hosted by Becker's ASC Review, Michelle George, RN, MSN, CASC, vice president of clinical services with Surgical Care Affiliates, and Lisa Sinsel, group director of clinical services with SCA, delved into the history of safe surgery checklists and how ambulatory surgery center leaders can make the most of these tools.  

Safe surgery checklists, though now a healthcare staple, began in the aviation industry during the 1930s. ASCs are now mandated to use these checklists, but each center is different. A checklist is only effective if used properly.

Back to basics
"Checklists are about team work, but medicine is about autonomy," said Ms. George. "That can be a bit of a barrier." A strong surgical checklist is rooted in a professional code of conduct and discipline. These elements hold all team members accountable and ensure the list helps create a culture that revolves around safety.

A checklist may seem unnecessary, but it in fact serves as a failsafe against preventable errors. "The ASC environment is fast-paced and there is a lot of turnover," said Ms. George. "The more complex a procedure the more opportunity there is to miss a critical step."

Building a list
Since the inception of safe surgery checklists in healthcare, several organizations have released templates and tools. CMS, The Joint Commission and the Accreditation Association for Ambulatory Health Care also all have requirements for safe surgery checklists. Resources for creating a checklist include:

•    The World Health Organization
•    SafeSurg.org
•    Association of Perioperative Registered Nurses
•    Ambulatory Surgery Center Association
•    Health Research & Educational Trust

"When developing a list or improving your current list, you will find examples to be helpful," said Ms. George. She suggested several questions to consider when building a center-specific list from a foundational tool, including:

•    Does the checklist have clear, concise objectives?
•    Has the checklist been trialed with frontline users?
•    Was the checklist modified for a better fit after being trialed?

Implementing a checklist
Once an effective checklist has been created, ASC leadership is charged with implementing it into their center's daily workflow. The essential starting point lies with a center's team. "Lack of engagement in the development and revision of the checklist is the number one reason for poor checklist pull through," said Ms. Sinsel. "In order to earn team buy-in, they need to feel involved."

The most important elements of earning team buy-in and successfully implementing a list, according to Ms. Sinsel, are:

•    Developing clear tools and processes to support execution
•    Setting expectations
•    Training
•    Identifying physicians that will champion the process
•    Agreement on usage commitments
•    Making changes after trial runs

"Raise the bar and be sure to share the results and successes across your organization," she said.

Download the webinar presentation here.

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