Webinar 16:
Are You Where You Want to Be?
Topics of Last Week’s Call
• OR Team Training Update
• Hospitals will share their experiences with
implementing the checklist at their
hospitals.
• Molly McBrayer, Bon Secours St. Francis
Hospital, Charleston
• April Howell, McLeod Regional Medical
Center
• Announcements
How Did the Homework Go?
Last Weeks Homework
• Continue/Start to administer the culture survey.
• Continue to talk with your colleagues one-on-one.
• If you haven’t already, hold the meeting that you scheduled at the beginning
of the call-series with as many surgical personnel that can attend. This can
be a large inter-disciplinary meeting or departmental meetings.
• Prioritize surgical specialties for the roll-out using your knowledge of which
surgeons will be most receptive to the checklist.
• Create a timeline for your hospital’s expansion and send it to the Safe
Surgery 2015 team at [email protected].
• Continue implementing the checklist.
• Use the Surgical Safety Checklist and Teamwork Observation Tools
together in five cases. If you are part of the research please send us the
completed observations.
Today’s Topics
• Tips on:
– Preventing problems
– Fixing problems
– What you can do now to enhance checklist use
• Looking into the future - What will it be like in three
months?
• Assessing where your hospital is in terms of
checklist implementation - Are you where you
want to be?
Preventing Problems
•
One-on-One conversations
Fixing Problems
• Coach surgical teams and individuals in
the OR.
• If you identify a team or team member that
is not using the checklist have an
individual or a team conversation.
What Could This Conversation
Look Like?
• Chief of Surgery learns that one of the
surgeons refuses to use the checklist.
• He sends the surgeon that refuses to use
the checklist an email asking him to come
to his office.
• “I heard that you don’t want to use the
checklist. Help me understand why?”
What Are Some Things You Can
Do Now?
• Use the observation tools to see how
team’s are using the checklist and coach
them.
• Collect and post instances of when the
checklist catches something.
• Consider having individual conversations
with some front-line staff, including
physicians and ask them how they think it
is going.
A Look Into Three Months in
the Future
A Hospital’s Story
• When they put the checklist into place they
did a fantastic job:
– Modified the checklist for their hospital
– They spread it slowly
– Measured the culture
– One-on-One conversations took place
– They performed observations in their ORs to
see how people were using the checklist
A Hospital’s Story:
3 Months Post Roll-Out
• They stopped monitoring the checklist once
they thought everybody was using it well.
• Front line staff reported that half of the time
the teams do not read off of the checklist,
instead they rely on memory.
• Trying to decide how to embed the checklist
into their EMR.
• Re-giving the culture survey, six months after
beginning the work.
What Do You Do When Things
Aren’t Where You Want Them To
Be
• Monitor how teams use the checklist with
the observation tools.
• Coach surgical teams and individuals on
how to improve their checklist
performance.
• Consider re-giving the culture survey.
IF YOU ARE GOING TO USE
THE EMR TO DOCUMENT THE
CHECKLIST GUARD
CAREFULLY AGAINST
TURNING THE CHECKLIST
INTO A “TICK THE BOX”
EXERCISE
Are You Where You Want To
Be?
Your Hospital’s
Implementation Team
1. Do you have an implementation team that
meets regularly? (This team should consist of at
least one Anesthesiologist/CRNA, Administrator, Nurse,
Scrub Tech, and Surgeon)
– Yes
– No
– We have an implementation team, but we do
not meet regularly.
– We do not have an implementation team yet.
Checklist Modification
1. Did you modify the checklist for your
hospital?
– Yes
– No
– We are still in the process of modifying the
checklist
Checklist Use
1.
Has at least one surgical team tried using your customized
version of the checklist?
– Yes
– No
2. Does at least one surgical team routinely use your
customized version of the checklist?
– Yes
– No
3. If you answered yes to question 2, what is the percentage
of surgical teams that are routinely using your customized
checklist?
– < 50%
– > 50%
– Every team is using the checklist
One-on-One Conversations
1. What percentage of your surgical staff
have you or your colleagues had one-onone conversations with?
–
–
–
–
0%, We have not had these conversations.
< 50%
> 50 %
We have had these conversations with all of
our physicians.
Observing Teams Using the
Checklist
1. Have you observed surgical teams in
your hospital using the observation tools?
– Yes
– No
This Week’s Homework
• Continue to:
– Implement the checklist
– Administer the culture survey
– Have one-on-one conversations with surgical
team members
Announcements
• We want to highlight all of the teams that have
done work to put the checklist into place in their
hospitals at the TAP Conference in September.
• If you haven’t already done so, please send us a
picture of your checklist implementation team.
• If you have strong “champions” that you would
like to highlight, please send us their headshots.
• Email all of your pictures to:
[email protected]
Questions
Ask Us a Question By Using the
Raise Hand Button
Office Hours:
Cancelled This Friday
Next Week’s Call:
Atul Gawande Will Be Joining Us
and We Will Talk About Keeping
the Checklist Going and Next
Steps in This Project
Resources
Website:
www.safesurgery2015.org
Email: [email protected]