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Aviation-Style Computerized Surgical Safety Checklist Displayed on a Large Screen and Operated by the Anesthesia Provider Improves Checklist Performance.
Jelacic, Srdjan; Bowdle, Andrew; Nair, Bala G; Togashi, Kei; Boorman, Daniel J; Cain, Kevin C; Lang, John D; Dellinger, E Patchen.
Afiliación
  • Jelacic S; From the Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington.
  • Bowdle A; From the Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington.
  • Nair BG; From the Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington.
  • Togashi K; From the Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington.
  • Boorman DJ; Boeing Test and Evaluation, The Boeing Company, Seattle, Washington.
  • Cain KC; Office of Nursing Research and Department of Biostatistics.
  • Lang JD; From the Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington.
  • Dellinger EP; Department of Surgery, University of Washington, Seattle, Washington.
Anesth Analg ; 130(2): 382-390, 2020 02.
Article en En | MEDLINE | ID: mdl-31306243
ABSTRACT

BACKGROUND:

Many hospitals have implemented surgical safety checklists based on the World Health Organization surgical safety checklist, which was associated with improved outcomes. However, the execution of the checklists is frequently incomplete. We reasoned that aviation-style computerized checklist displayed onto large, centrally located screen and operated by the anesthesia provider would improve the performance of surgical safety checklist.

METHODS:

We performed a prospective before and after observational study to evaluate the effect of a computerized surgical safety checklist system on checklist performance. We created checklist software and translated our 4-part surgical safety checklist from wall poster into an aviation-style computerized format displayed onto a large, centrally located screen and operated by the anesthesia provider. Direct observers recorded performance of the first part of the surgical safety checklist that was initiated before anesthetic induction, including completion of each checklist item, provider participation and distraction level, resistance to use of the checklist, and the time required for checklist completion before and after checklist system implementation. We compared trends of the proportions of cases with 100% surgical safety checklist completion over time between pre- and postintervention periods and assessed for a jump at the start of intervention using segmented logistic regression model while controlling for potential confounding variables.

RESULTS:

A total of 671 cases were observed before and 547 cases were observed after implementation of the computerized surgical safety checklist system. The proportion of cases in which all of the items of the surgical safety checklist were completed significantly increased from 2.1% to 86.3% after the computerized checklist system implementation (P < .001). Before computerized checklist system implementation, 488 of 671 (72.7%) cases had <75% of checklist items completed, whereas after a computerized checklist system implementation, only 3 of 547 (0.5%) cases had <75% of checklist items completed.

CONCLUSIONS:

The implementation of a computerized surgical safety checklist system resulted in an improvement in checklist performance.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Procedimientos Quirúrgicos Operativos / Terapia Asistida por Computador / Competencia Clínica / Personal de Salud / Lista de Verificación / Anestesia Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Anesth Analg Año: 2020 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Banco de datos: MEDLINE Asunto principal: Procedimientos Quirúrgicos Operativos / Terapia Asistida por Computador / Competencia Clínica / Personal de Salud / Lista de Verificación / Anestesia Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Anesth Analg Año: 2020 Tipo del documento: Article