In the fall of 2008, perioperative leaders at Brigham and Women's Hospital, Boston, Massachusetts, conducted a two-week trial of the World Health Organization Surgical Safety Checklist in the main OR. The checklist was incorporated by using a Plan-Do-Study-Act cycle. In 2009, we began a 14-week rollout of the surgical safety checklist to all our ORs. Critical factors that led to the success of this implementation included gaining executive leadership endorsement; recruiting volunteers from each discipline to lead the project; using quality methodologies to ensure a thoughtful, organizing implementation; providing frequent feedback and data; and confirming standardized use of the checklist by creating a policy.

Nursing leaders at one facility challenged staff nurses in the postanesthesia care unit (PACU) to implement a modified process of shared governance, a model that allows staff nurses to influence their practice. As a result of this initiative, PACU nurses were able to collaborate with other perioperative staff members, ultimately increasing patient safety. Successes included increased staff nurse participation in educational projects; increased interdisciplinary collaboration; personal and professional development for the nurses involved; and recognition from a highly esteemed, national organization.

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