Society of University SurgeonsImplementing a surgical checklist: More than checking a box
Section snippets
Context
An observational study was performed at Children's Memorial Hermann Hospital (CMHH), which is a 240-bed children's hospital within the tertiary Memorial Hermann Hospital Texas Medical Center. CMHH is 1 of 11 hospitals in the Memorial Hermann Hospital system (MHHS). CMHH is a teaching hospital; in addition to attending physicians, pediatric surgery and anesthesia fellows and residents are involved in operative cases. At the time of this study, the pediatric and adult ORs were under the same
Results
During the 7-week observational period, 142 total operations were observed. All of the pediatric surgery subspecialties at CMHH were included in the study (Table II). These operations involved 19 different attending pediatric surgeons with a median of 4 cases each (range, 2–23), and 9 anesthesiology attending physicians with a median of 20 cases each (range, 2–27). Most (98%) of cases were performed in the OR, and the median case length was 45 minutes (range, 3–415).
The BSI phase of the
Discussion
Our study showed that although compliance with the perioperative checklist was documented in 100% of observed cases in the electronic medical record, adherence to individual components of the checklist was significantly less. The BSI checklist was carried out in 97% of cases, but only 4 observed cases demonstrated completion of more than 7 of 13 checkpoints (Table I). These results are consistent with other studies demonstrating variation in implementation fidelity of checklists.6, 8, 10 For
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