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ORIGINAL ARTICLE
Year : 2015  |  Volume : 2  |  Issue : 2  |  Page : 41-46

Implementation of surgical safety checklist for all invasive procedures


1 Department of Quality, Fortis Escorts Heart Institute, New Delhi, India
2 Department of Cardiology, Fortis Hospital, New Delhi, India
3 Department of Medical Administration, Medanta - The Medicity, Gurgaon, Haryana, India

Correspondence Address:
Dr. Akanksha Patel
Department of Quality, Fortis Escorts Heart Institute, Okhla, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2319-1880.174347

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Context: The purpose of this study was to analyze the implementation of the surgical safety checklist (SSCL) for all invasive procedures and compliance with the SSCL to determine further improvements. Aims: To implement the SSCL for all invasive procedures within 6 months and achieve 80% compliance. Settings and Design: Various invasive procedures selected that have comparatively risks of errors. Modified the SSCL based on essential requirements of the procedure. Materials and Methods: The implementation of the SSCL was observed for all identified invasive procedures. Checklists were piloted, rolled out, and monitored. Statistical Analysis Used: Plan-Do-Study-Act (PDSA) and Pareto principle were used for implementing the SSCL and analyzing the hurdles for implementation. Results: During this exercise, the checklist for the various invasive procedures was finalized after a brainstorming sessions with various stakeholders. All the checklists were developed with the help of the World Health Organization (WHO) surgical safety principle between March 2013 and May 2013. Sensitization and training for the checklist were done among all relevant staff. All the checklists were piloted for June 2013 and the compliance of checklist usage was monitored. The sample for audit was decided. The rates of compliance for various procedures during the pilot phase of the study were 50% for dental extractions, 60% for cataract surgeries, 35% for endoscopy, 20% for cystoscopy, 40% for cardiac catheterization procedures, and 0% for bronchoscopy procedures. Compliance reviewed and changes made based on feedback received from users for checklist finalization. After the intervention, compliance monitoring for the same sample size at a defined frequency is done and shared with relevant stakeholders when required. Conclusions: Implementation needs constant monitoring, retraining, and reinforcement until it becomes self-evident and accepted.


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