333 - All Aboard!: Strategies to Standardize an Operating Room’s Count Sheet
Description: In an operating room environment, patient safety is paramount throughout all aspects of surgery. From the surgical time out to specimen handling to surgical counts, small improvements in OR safety can add up to substantially better patient outcomes. Efficiency in these processes can also portend to substantial time and cost savings to a healthcare organization over time. Promoting an efficient and safe surgical count process is a strategy that can help prevent retained surgical bodies or miscounts, thus promoting optimal patient care. The first step in this process is to standardize the count sheets. Standardization is necessary due to the convergence of several factors including ambiguous writing styles, increasing age of the nursing population and environmental influences such as time constraints and poor lighting during some surgical cases. Standardization of operating room count sheets has the potential to improve efficiency by decreasing errors in handwriting interpretation therefore reducing the number of miscounts. Decreasing surgical miscounts, coupled with the elimination of unneeded x-rays, enables the surgical team to operate more efficiently and streamline their procedures, saving money and increasing patient safety and staff satisfaction.The team was multidisciplinary and spanned across eight (8) campuses. Planning included the identification of risks associated with the surgical count process and development of mitigation strategies for the highest risk failure modes. Assessment included observations of workflow, staff interviews, staff surveys, literature review, review of internal quality reports and root cause analyses. Pre-implementation count discrepancies were 17+ instances per month.At our campus, implementation was effective July 2, 2018. Clinical support personnel were immediately available onsite to provide assistance with the new standardized count sheet.Results were as follows: Month / Number of Count Discrepancies July 2018 14 August 2018 13 September 2018 14 October 2018 14 November 2018 14 December 2018 9 January 2019 9 The project demonstrates how utilization of a standardized count sheet has the potential to decrease surgical count discrepancies, save precious healthcare resources, and reduce the likelihood of retained foreign bodies.