Safe surgery checklists are evidence-based, standardized lists of items that healthcare teams should complete before, during, and after a surgical procedure. This checklist allows teams to document the actions they take. This documentation verifies that the surgery team is following safety protocols.
By improving communication, encouraging teamwork, and providing a clear framework for decision-making, safe surgery checklists help ensure that the best possible surgical quality is achieved and patient safety is not compromised. The growing popularity of safe surgery checklists reflects their increased use — and success — across hospitals and healthcare organizations worldwide.
Below is a measured analysis of safe surgical checklists as a tool for healthcare teams, outlining not just their impact but also best practices for their implementation.
The History of Safe Surgery Checklists
Safe surgery checklists are not a new concept. The World Health Organization (WHO), as part of their patient safety agenda, developed the first checklist in 2002. Since then, research has consistently shown the positive impact of using checklists for surgical teams. In 2009, the WHO issued guidelines calling for hospitals to incorporate safe surgery checklists into their operating rooms.
Safe surgery checklists have experienced success in many surgical settings since their invention, from open-heart surgeries to laparoscopic procedures. Besides providing a clear framework for patient safety, checklists also help hospitals improve quality assurance programs and ensure that medical staff is properly trained.
The Importance of Safe Surgery Checklists
For every member of the surgical team, safe surgical checklists are becoming increasingly popular because they provide a few key benefits to even the best teams. Here are some important advantages:
- Reduced errors and complications
By following a set of standardized instructions, healthcare teams can reduce errors and preventable complications. Checklists provide an opportunity to review potential risks before the procedure begins, ensuring that teams take every necessary step to protect patients.
- Improved communication among surgical team members
By utilizing safe surgery checklists, healthcare teams can improve their communication and ensure they take all necessary steps to protect patients. Checklists provide an opportunity for team members to communicate effectively and openly discuss the specifics of the procedure before it begins. This process helps eliminate confusion or gaps in information, allowing for better collaboration among members of the surgical team.
- Standardization and streamlining of procedures
Safe surgery checklists provide a standardized set of instructions that all types of surgical settings can use. This standardization ensures that teams follow best practices and patients receive the highest quality of care. It can also streamline processes and reduce time spent in the operating room.
By providing a clear set of instructions, healthcare teams are better able to anticipate challenges and plan accordingly. As a result, there is less wasted time and resources during the procedure, allowing for faster turnaround times and improved cost-effectiveness.
- Iterative improvement and feedback implementation
Such checklists also provide an efficient way to ensure teams minimize potential risks in future surgeries by identifying areas of improvement in advance and allowing clear standards for measurement of each step of the surgical process.
These checklists can ensure no improvement gets lost to memory when a procedure is complete. This is especially important when refining responses to actual or potential adverse events that might occur during a particular surgery.
How to Implement Safe Surgery Checklists
Implementing safe surgical checklists in a healthcare organization can be tricky business if you don’t know where to start. Here are a few key steps to ensure this tool is incorporated into your standard operating procedures.
- Identify key stakeholders
Gather all relevant team members in the process, including surgeons, nurses, anesthesiologists, CRNAs and whoever else is in the room, to ensure that your checklist is both comprehensive and collaborative. This is essential to guarantee every party is invested in the use of the checklist as well as to provide an opportunity for input in its development. It is also important to involve patients in the checklist development process, as patient advocates and the patient’s point of view can be valuable resources in ensuring patient satisfaction.
- Create the checklist
Once you identify stakeholders, the next step is to create a checklist that meets the needs of your surgical team. This checklist should include all steps the team needs to complete before, during, and after the procedure. You may want to consult with other experienced surgeons and healthcare staff during this process as well as consulting best practices in each specific area.
Many hospitals are transforming their surgical safety time out protocols to leverage technologies that make it easier to prepare safety checklists for every stage of the surgical process. An automated system makes it easier for OR staff to capture important case milestones in real time and improves the accuracy of time-stamped data.
- Train surgical team members
Once you develop the checklist, it is important to train all relevant team members on how to use it. This process ensures that everyone is familiar with the checklist and can effectively use it in the operating room.
Because checklists constantly evolve, it is important to provide regular training sessions on the latest best practices. Training sessions can also help reinforce the importance of following the checklist and ensuring patient safety.
- Implement and integrate into the surgical workflow
Once you train team members, integrate the safe surgery checklist into the surgical workflow. This process helps ensure that the team is following all steps and are on the same page. It also helps to create a standardized process throughout the entire facility.
Evaluate the checklist regularly and make improvements as needed. Implementing regular audits can identify any weaknesses or opportunities for improvement.
The Impact of Safe Surgery Checklists on Patient Outcomes
As the WHO attests, the use of standardized checklists throughout the surgical process can lead to fewer errors, better communication, and improved patient satisfaction. These benefits are especially valuable in settings where time is a critical factor, such as trauma care or emergency surgeries. Below are some key findings:
- Reduced mortality rates
Studies have shown that implementing safe surgery checklists can lead to a decrease in mortality rates. This decrease is largely due to improved communication, fewer errors, and more standardized processes throughout the entire procedure.
- Reduced complications
Checklists can also help reduce the number of errors and complications during surgery. By identifying any potential issues before the procedure, healthcare teams are better equipped to provide safe care and ensure positive patient outcomes.
- Improved patient satisfaction
Finally, the use of checklists can lead to improved patient satisfaction. By ensuring all steps are completed before, during, and after a procedure, patients can feel more secure that providers take their care seriously. This reassurance leads to increased trust and greater satisfaction with the care provided.
Safe surgery checklists can have a positive impact on patient outcomes, but they require proactive efforts to implement. By identifying key stakeholders, creating the list, training team members, and implementing the checklist into the surgical workflow, healthcare organizations can ensure their patients receive the best care possible as consistently as possible.
Aileen Killen, Ph.D., RN, CPPS
Aileen Killen, Ph.D., RN, CPPS, brings a wealth of clinical experience and thought leadership in patient safety and perioperative nursing to her role as director of perioperative operational excellence at LiveData. Her career has included leadership positions in some of the country’s leading academic medical facilities including New York University Medical Center, Hospital for Special Surgery, Dartmouth-Hitchcock Medical Center, and Memorial Sloan Kettering Cancer Center. As the first director of patient safety programs at Memorial Sloan Kettering, Aileen established institutional guidelines, metrics, and standards for overall quality of patient care. Prior to joining LiveData, she was global head of healthcare, client risk solutions and casualty risk consulting, at AIG. For more information on LiveData, a surgical workflow software company, please visit www.livedata.com and follow the company on LinkedIn.