Oral Themed Presentation
Background: : The WHO Surgical Safety checklist has been widely implemented on the basis of initial research supporting its positive impact on patient safety. We sought to assess compliance with its use within pediatric Otolaryngology (ORL) simulation teamwork scenarios.
Research Question: : Are WHO Surgical Safety Checklists being performed more successfully by attending surgeons than fellows?
Methodology: : Pediatric ORL simulation scenarios were performed within actual operating room
(OR) environments (in situ). The purpose of these scenarios was to promote
teamwork within and between surgical services. The participants were comprised of
ORL surgeons, OR nurses and anesthesiologists. The ORL teams were led by either an
attending or a fellow. Video analysis of the implementation of the WHO checklist by
the surgical team at ‘time out’ was assessed according to the validated WHO-BARS
Results: : Forty-seven scenarios were analyzed from 2011 and 2018. Review of the videotapes showed that the mean WHO-BARS communication scores improved from 4.8 (2011-14) to 5.6 (2015-18) during this time. This is indicative of greater compliance with the process over this eight-year period (p value = 0.0127). There was no statistically significant difference demonstrated between fellow or attending performance of the checklist or time taken in performing the checklist. On 10 occasions (21.3%) within the analysis, a team member ‘challenge’ within the WHO checklist procedure led to a change in intended patient management or corrected an incorrect assumption of another team member.
Discussion/Conclusions: : While past studies have shown that adopting the WHO Surgical Safety Checklist has resulted in improved patient outcomes, utilization of a proper checklist has been problematic in some institutions. This analysis shows a steady improvement in checklist use during a series of in situ OR simulation experiences during the eight-year study period.