Quality Improvement Initiative
Purpose of a Pre-operative Checklist
Surgery is a medical option offered as a treatment or a preventive measure for certain diseases. Although some surgeries are minor, all surgical processes are done with utmost care to ensure recovery and prevent patient deterioration while preventing new complications due to the surgery. Surgery complications and errors should be prevented, beginning with the period before the surgery. This involves making sure the patient is booked in for the right surgery and receiving proper care, such as stopping medications that may make surgery difficult. Current statistics have shown that seven out of ten surgery errors are caused by mistakes that occurred before the actual surgery (Willassen, Jacobsen, & Tveiten, 2018). While several measures can be taken to prevent this, a pre-operative checklist is one of the best ways to avoid mistakes prior to surgery. A pre-operative checklist is organized such that all essential patient information is recorded before their surgery. These details include their name, the type of surgery they are being booked for, the time of surgery, current medication, and professionals involved.
Target Population
Introducing a pre-operative checklist in hospital targets different people, including doctors, nurses, anesthetists, and patients. Everyone who is involved in the surgical process is reminded of their roles before and during the surgery. First, the patient is notified to adequately prepare for the surgery, for instance, by stopping medication at a designated time and organizing for their post-operative care if necessary (Tostes & Galvao, 2019). Hospital staff are targeted as they need to clean and prepare the surgery room in time for the operation to begin. Different specialists, such as neurosurgeons or cardiologists, are also targeted to clear their schedules to accommodate the patient. Also, general physicians may need to check for any underlying conditions before the patient is approved for surgery.
Benefits of a Pre-operative Checklist
A pre-operative checklist will benefit a healthcare institution by reducing the number of complications arising from preventable causes. For instance, a patient taking medicine containing blood thinners is likely to have surgery complications if the medicine is not stopped for some time before the operation. A checklist will ensure the medicine is halted and prevent the corresponding complication. Second, the checklist will prevent surgery errors, including booking a patient for the wrong surgery (Haynes, et al., 2012). In some instances, a patient has been booked for the wrong surgery only to be realized once in the operating room or after the surgery has begun. Third, the checklist will enhance and streamline communication among healthcare workers. This benefit is not limited to communication regarding surgery alone but overall communication in the institution. Fourth, everyone involved in the surgical process will be required to take responsibility for their roles to prevent errors or in case of one. This is because a checklist will ensure all roles are clearly distributed and used as a reference if a specific role is not completed. This further encourages participation in the surgical process.
Interprofessional Collaboration
A pre-operative checklist guarantees interprofessional collaboration as it brings together healthcare workers from different departments. Physicians, nurses, surgeons, cleaners, and other professionals all need to collaborate in the implementation of the checklist. Collaboration is a primary requirement as the checklist is established on the need for different professionals to be accountable for their pre-operative and operative roles, thus promoting patient safety. First, the doctor makes the diagnosis and determines the need for surgery. They also prescribe and set the timeline for necessary medication. The doctor has to communicate with the nurse on the patient’s needs and with the surgeon involved to discuss the patient’s condition (Pugel, Simianu, Flum, & Dellinger, 2016). After that, all stakeholders have to determine the surgery date based on the patient’s condition and their availability or schedules.
Cost Justification
Fortunately, designing or adopting a pre-operative checklist does not require a huge budget. The entire process demands more time than financial input. The time is spent on ensuring that all pre-surgical processes are considered and included in the checklist and that every stakeholder is involved. As such, workers from different departments will need to take time off their routine activities to ensure the process’s efficient completion. Also, time will be spent on educating the employees on the checklist, particularly how to use it and its importance. As a result, the institution has to adjust and continue operations without all the workers until the checklist-designing process is complete. Financially, money is required to cater to technological costs and office requirements, such as papers and pens.
Evaluation
Currently, the hospital has records that contain data on the number and frequency of surgical errors and complications that could be prevented before the actual surgery. After the implementation of the checklist, the data is used as a reference for the analysis. It will determine whether the checklist has any implications on surgical errors and complications, and consequently, its effectiveness as a quality improvement initiative.
References
Haynes, A. B., Weiser, T., Berry, W., Lipsitz, S., Breizat, A.-H., Dellinger, P., . . . Joseph, S. (2012). A Surgical Safety Checklist to Reduce Morbidity. Retrieved from World Health Organization: https://www.who.int/patientsafety/safesurgery/Surgical_Safety_Checklist.pdf
Pugel, A. E., Simianu, V. V., Flum, D. R., & Dellinger, P. E. (2016). Use of the Surgical Safety Checklist to Improve Communication and Reduce Complications. J Infect Public Health.
Tostes, M. F., & Galvao, C. M. (2019). Implementation process of the Surgical Safety Checklist: integrative review. NCBI.
Willassen, E. T., Jacobsen, I. L., & Tveiten, S. (2018). Safe Surgery Checklist, Patient Safety, Teamwork, and Responsibility—Coequal Demands? A Focus Group Study. Global Qualitative Nursing Research.