2017 HSC Section 2 - Practice Management

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Russ et al Annals of Surgery Volume 258, Number 6, December 2013
TABLE 3.
(Continued
)
Authors
Type of Checklist
Outcome and Tool
Design and Sample
Findings
Limitations
∗
Henrickson et al
33
Patient-specific preoperative
briefing checklist
Outcome: Observed surgical flow
disruptions related tomiscommunication
Tool: Real-time OR observations
Pre/postobservational studyPre
=
10 observations
Post
=
6 observations
After implementation of briefings
there were significantly (53%)fewer miscommunication eventsper case (1.17 post vs 2.5 pre)
Small sample sizeThe observer was a medical
student with limited clinicalexperience.
Observer was not blinded to
whether the teams had beenbriefed or not
Einav et al
34
Patient-specific preoperative
briefing checklist(presented in poster formatin all ORs)
Outcome: Observed near-misses
associated with problematicteamwork
Tool: Real-time OR observations
of nonroutine events associatedwith problems in teamwork
Pre/postobservational studyPre
=
130 observations
Post
=
102 observations
A significant reduction in the mean
number of nonroutine eventsassociated with poor teamworkafter implementation of thechecklist.
Nilsson et al
35
WHO Surgical Safety
Checklist
Outcome: Perceived “team
feeling” in the OR
Tool: 1 “Team”-related item on
study-specific questionnaire
Surveys 1 yr after checklist
implementation
331 respondents147 surgeons, 30
anesthesiologists, 63anesthetic nurses, 44 ORnurses, and 47 nurseassistants
65% agreed that the “Time-out”
strengthens the team feeling in theOR
Lack of “pre” intervention
questionnaire—no control
No mention of origin of
questionnaire items and novalidity/reliability dataavailable
Only 1 questionnaire item related
to impact of checklist onteamwork
Papaspyros et al
36
Patient-specific preoperative
briefing and postoperativede-briefing checklist
Outcome: Perceived quality of
communication
Tool: Interviews
Qualitative interview study
postintroduction ofbriefings/checklist
15 intervieweesAnesthesiologists,
perfusionists, scrub nurses,and technicians
The checklist/briefings were
perceived to have improvedcommunication in the OR
Small sample sizeNo control (lack of prechecklist
assessments)
Qualitative analysis of attitudes
only—no significance testing
No validity/reliability data
available for interviewapproach
Calland et al
37
Patient-specific safety
checklist with pre-, intra-,and postoperativecomponents
Outcome: Observed team
coordination andcommunication. Perceivedteam communication andsituational awareness.
Tool: Observations of team
coordination andcommunication by expertsusing the RATE tool fromvideo recordings. Multipleitems on study-specificquestionnaire
RCT—control group and
checklist/interventiongroup. Observationsconducted retrospectively.Surveys conductedpostprocedure
Control group
=
no
checklist—23 casesobserved, 142 surveyrespondents
Intervention group
=
checklist—24 casesobserved, 139 surveyrespondents
Observations: Favorable team
communication and coordinationbehaviors were rated higher in theintervention group.
Surveys: Perceptions of team
efficiency and communicationwere poorer in the interventiongroup. Perceptions of situationalawareness did not significantlydiffer between groups.
Some residents and other staff
may have contributed in bothintervention and controlcases—possible contaminationof results (the attendingsurgeon was the only teammember who was clearlyassigned to either control orintervention group).
The checklist was not always
performed as intended
No mention of origin of
questionnaire item and nopsychometric data presented
Researchers who scored video
observations were not blindedto experimental group
Only 1 questionnaire item related
to impact of checklist on teamcommunication
(continued
)
| C 2013 Lippincott Williams & Wilkins
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