Clinical Public Reporting
The Ontario Hospitals Association made the use of a Surgical Safety Checklist mandatory for all hospitals.
The use of a checklist was not new to our hospitals. For years, the operating room staff have used perioperative checklists, anaesthesia checklists, and surgical equipment checklists and counts. So the use of a checklist is not new, but the public reporting of the use of the tool was new.
The tool calls for team discussions and checks at three critical points during surgery:
- Briefing: Preoperative evaluation of the conscious patient prior to induction of anesthesia.
- Time Out: Immediately prior to incision
- Debriefing: Postoperatively prior to the patient leaving the operating room.
The three checks are to be performed on every case, including cases that only require a local anaesthetic or light sedation. In reporting our compliance, we only counted cases where all three checks were documented. It is important to note that the three checks were completed and documented on all cases requiring a general anaesthetic. Since the majority of our O.R. cases require some light sedation or freezing only, and the actual O.R time is short, it has been a period of adjustment for staff to ensure the three checks are completed on the lighter cases. We have assessed what worked well, and where we need to improve as far as ensuring the three checks are documented. We have put some changes in place at the start of the second quarter, July 1st which will assist staff in ensuring that the documentation is completed on every case.