Patient safety remains the most important priority for CHEO and this involves ensuring a safe experience for patients who undergo surgery here. Our patients can expect safe, high quality care, and one tool used to help ensure a positive patient care experience is a surgical safety checklist.

The Surgical Safety Checklist has been an improvement project undertaken by one of the 7 “Lean” teams in Perioperative Services. Led by Karen Lowe, we provided a “big bang” renewal of the education and commitment from Surgery, Anesthesia and Nursing that would lead to successful and consistent implementation of the SSCL on September 7 2011. Previously we had adhered to many of the components of the checklist, but not in the uniform way that the reporting required. We are monitoring the SSCL compliance on a daily and weekly basis with results posted for all staff and physicians to view. Our goal is to be equal to or better than the results for academic facilities in Ontario.

What is a surgical safety checklist?

A surgical safety checklist is a patient safety communication tool that is used by a team of operating room professionals (nurses, surgeons, anesthesiologists, and others) to discuss important details about each surgical case. In many ways, the surgical checklist is similar to an airline pilot’s checklist used just before take-off. It is a final check prior to surgery used to make sure everyone knows the important medical information they need to know about the patient, all equipment is available and in working order, and everyone is ready to proceed.

What information is included in a surgical safety checklist?

Some examples of items contained in the checklist:

The Briefing Phase:

• Verify with patient name and procedure to be done

• Allergy Check

• Medications Check

• Operation site, side and procedure

• Lab tests, xrays

The “Time Out” Phase:

• Patient position

• Operation site and side and procedure

• Antibiotics check

The Debriefing Phase:

• Surgeon reviews important items

• Anesthesiologist reviews important items

• Nurse reviews correct counts

Will a surgical safety checklist be used on my child?

If your child undergoes a surgery at CHEO, you can expect that the surgical safety checklist will be used as part of the procedure. It will be used by our health care team before, during and after your child's surgery to help the health care team familiarize themselves with your child's medical history and any special requirements that may be needed for his or her individual case.

How is the indicator calculated?

The percent compliance is calculated as follows:

 # of times all three phases of the surgical safety checklist was performed x 100 = % compliance

                                 Total surgeries

The surgical safety checklist is considered “performed” when the designated checklist coordinator confirms that surgical team members have implemented and/or addressed all of the necessary tasks and items in each of the three phases: Briefing; Time Out; and Debriefing. Therefore, the SSCL compliance indicator is a process measure, measuring the degree to which all three phases of the SSCL was performed correctly and appropriately for each surgical patient.

The aim of the checklist is not to be cumbersome or to take a significant amount of time, ut to engage the whole team in key conversations about the patient and the procedure. Many organizations such as CHEO do this now – but perhaps not in an organized fashion with all team members present and contributing to that conversation. Any one of the Surgical Team can lead the checklist conversation – Anesthesia, Nursing or the Surgeon.

More information and translations into different languages of this information is available on the OHA website at: http://www.oha.com/patientsafetytips