2017 HSC Section 2 - Practice Management

Annals of Surgery Volume 258, Number 6, December 2013

The Impact of Safety Checklists on Teamwork in Surgery

( continued )

General surgery, plastic surgery, neurosurgery

General surgery, plastic surgery, neurosurgery

Simulations of general and

vascular surgery procedures

TABLE 1. Study Characteristics Authors Year Type of Checklist Outcome Assessed ∗ Study Methodology † Country Setting Surgical Specialty Teamwork climate Survey—Pre/post USA, Orange County Multispecialty

General surgery

Vascular surgery

General surgery

USA 1 tertiary academic center

USA 1 tertiary academic center

Canada 1 tertiary academic center

1 medical center at an integrated managed care consortium

academic center

UK, London 1 large university hospital

Canada 1 tertiary academic center

Canada 1 quaternary

(6 months before checklist implementation and 6 months after).

Surveys—pre/post (Pre–data collection lasted 5 months, checklist was

implemented for 3 months, post–data collection lasted 2 months)

Surveys—Pre/post (pre–data collection lasted 2 months, checklist was

implemented for 3 months, post–data collection lasted 2 months)

Observation (real ORs)—Post (Checklist implementation took place over 7 weeks during which observations were conducted.)

Interviews and observations (real ORs)—Post

(Checklist implementation took place over 7 weeks during which observations were conducted)

Surveys and observations (in simulated OR)—pre/post

(Simulation session lasted 4–5 h in total. One scenario was completed without the checklist at the start of the session, another was

completed with the checklist at the end of the session) Observations (real ORs)—pre/post

(Pre–data collection lasted 5 months, the checklist was then implemented over 3 months, post–data collection then

commenced over 5 months. The study lasted 13 months in total.)

Team building and exchange of information

quality of decision making

Communication breakdowns resulting in delays in

starting surgical procedures

Quality of teamwork (decision making, communication,

leadership, and overall

teamwork) and perceived impact of checklist on teamwork and communication

Communication failures and perceived impact of

checklist on proactive team communication

Negative teamwork events specifically linked to checklist usage

Team coordination and

preoperative briefing checklist

checklist designed to prompt preoperative discussion

preoperative briefing checklist

preoperative briefing checklist

checklist with pre, intra- and postoperative components

checklist designed to prompt preoperative discussion

checklist designed to prompt preoperative discussion

DeFontes and Surbida 24 2004 Patient-specific

Lingard et al 25 2005 Patient-specific

Makary et al 26 2007 Patient-specific

2008 Patient-specific

Koutantji et al 28 2008 Patient-specific safety

Lingard et al 29 2008 Patient-specific

2008 Patient-specific

Nundy et al (same group as above) 27

Whyte et al (same group as above) 30

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