Multifaceted interventions improve adherence to the surgical checklist

Teamwork, communication and safety climate: a systematic review of interventions to improve surgical culture

“…However, there was no change in nurses' response to ‘nurse input is well received’ after the intervention 16. Similar, partial improvement in culture was reported in 13 other studies 15–17 22 27 30 32 34 37 41 46 49 50. Of note, two of the four RCTs also reported no improvement in at least one domain of culture 31 43…”

“…Checklists were either implemented as an isolated intervention or as a component of a more comprehensive intervention bundle (eg, medical team training (MTT), central line insertion bundles). In some cases, checklists used the WHO Surgical Safety Checklist without any content modification 21 34 41 49 51…”

Validation of data submitted by the treating surgeon in the Victorian Audit of Surgical Mortality

“…Accurate information is crucial to obtain meaningful outcomes when surgical peer review is performed. Russ et al 16 and Putnam et al 17 had similar findings for sign-in and sign-out records, particularly omissions in 39% of cases, largely due to uncertainty about when to record these precisely. This is similar to other source validations conducted on other Australian clinical audits such as our Queensland counterparts who found an overall agreement of 98.2% 9 or the Victorian Cardiac Outcomes Registry, which found a 97.4% agreement between their data and hospital medical records.…”

“…The high concordance achieved for these data points compares favourably with national and international figures 8,9 which reassure the audit office that the peer review process is based on accurate source information provided by the treating surgeon. 16,17 Adherence to surgical safety checklists and accurate completion of forms remain a challenge within hospital settings. 14 It is noted that the use of TED stockings appears in the nursing notes rather than in the drug charts, as the task of prescribing deep venous thrombosis prophylaxis often falls to junior members of a clinical team 15 and the responsibility of completing the VASM audit falls upon the consultant surgeon.…”

A ‘paperless’ wall-mounted surgical safety checklist with migrated leadership can improve compliance and team engagement

“…The importance of this goal was stressed in a recent editorial by Haynes et al ,11 which stated ‘no quality tool, particularly one that relies upon team communication and interaction, can be expected to make a difference if it is not actually used in any meaningful sense’. It is recognised that optimising the use of a surgical safety checklist is difficult and requires a multifaceted approach 12. The use of a wall-mounted Checklist as opposed to a paper Checklist and the sharing of leadership as opposed to vesting responsibility for leading all domains solely in the OR nursing subteam are two such ‘facets’ that may contribute to achieving optimisation.…”