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The volume and complexity of knowledge today has exceeded any single individual's ability to manage it consistently without error despite advances in technology, years of training, and specialization of functions and responsibilities. Checklists have been employed since the 1930s in aviation and high-risk industries to prevent accidents caused by human error. Only recently has their use been introduced to surgery after the World Health Organization (WHO) heightened awareness of the significant number of deaths, about a half million worldwide, that occur each year as a result of avoidable surgical error.1 With over 275,000 surgical procedures performed daily, an emphasis on perioperative safety is a necessity.2
The WHO developed the first surgical safety checklist for use in the operating room in 2007. Since implementation, the checklist has reduced morbidity and mortality by over 30%.3 Subsequently, many hospitals have adapted and implemented checklists to improve patient outcomes. Moreover, the Centers for Medicare & Medicaid Services (CMS) recommended the use of surgical safety checklists as a quality measure in 2016. Thomas Jefferson University Hospital (TJUH) implemented a formalized time out procedure based on the WHO checklist with assistance from the LifeWings project for patient safety in 2013.
The original objective of the WHO checklist was for use in all settings where surgery takes place. However, there is increasing consensus that checklists should be customized to meet the needs of different surgical specialties in order to ensure optimal safety.4,5 The TJUH iteration of the WHO surgical safety checklist is centered on a time out procedure that occurs prior to incision, but after administration of anesthesia. Otolaryngology patients and operations can be complex, requiring advance communication and planning, prior to bringing each patient to the operating room, to safely secure the airway and obtain the necessary surgical equipment.
Our objectives were 1) to assess perceptions of operative safety and teamwork among nurses, otolaryngologists and anesthesiologists; and 2) to implement a preoperative surgical safety checklist to improve perioperative teamwork and communication.
Poster presented at Thomas Jefferson University House Staff Quality and Safety Poster Day.
Benefits of a surgical safety checklist for otolaryngology patients
Goodstein, MD, Lindsay A.; Mostovych, MD, Nadia K.; Hall, MD, Michael B.; Hsu, MD, David; Cognetti, MD, David; and Boon, MD, Maurits S., "Benefits of a surgical safety checklist for otolaryngology patients" (2016). Department of Otolaryngology-Head and Neck Surgery Posters. 6.