Webinar 10:Preparation for Expansion to Full Implementation –

Advertizing the Checklist

Summary of the Last Call• Identifying the people that might not want to use the

checklist and strategies to use when you talk to them.

• A hospital shared their experience working with skeptical physicians.

• Organizing your implementation team to conduct one-on-one conversations.

• Presenting this work to surgeons. I gave a demo presentation specifically targeted towards surgeons.

How Did the Homework Go?

Homework to Date Slide 1 of 3

• Build an implementation team.

• Schedule a time and venue for a meeting to take place after January.

• Download the OR Personnel Spreadsheet from our website and begin completing the information with the names, roles, and email addresses if relevant.

• Review the checklist modification guide and South Carolina Checklist Template.

• Modify the checklist with your implementation team and use it in a “table-top simulation”.

• Test the checklist with one team and modify if necessary.

Homework to DateSlide 2 of 3

• Email us a picture of your checklist implementation team.• Identify departmental meetings to have the

implementation team speak after call 10.• Expand the testing of the checklist to one team using the

checklist for every case for one day. Modify the checklist as necessary.

• Email us your hospital’s checklist. • If you haven’t already done so, please call or email our

team about whether you would like to administer the culture survey.

• Email everything to safesurgery2015@hsph.harvard.edu

Homework to DateSlide 3 of 3

• Identify people that you think will be skeptical of using the checklist.

• If possible we would like for you to start organizing yourselves for the one-on-one conversations.

• Start conducting one-on-one conversations.

Poll 1: Since Our Last Call, Have You Had One-on-One Conversations with people

that work in the OR?• Yes• No, but we are planning on conducting

them over the next several weeks• No and we are not planning on conducting

them.

Poll 2: If You Answered Yes, How Did it Go?

(Please Check All That Apply)• Good, it helped engage them in the

project.• Okay, I don’t know if it made a difference.• It did not go well.

Our Trip to South Carolina• One-on-one conversations with physicians.• Difference between the JC Timeout and the

checklist.

Today’s Topics• Patient Safety Symposium Announcements.• Finalizing your hospital’s checklist, a few

reminders. • Advertising this project in your hospital.• Two ASC’s will be sharing how they advertized

the checklist in their facility.• Training your colleagues using a demonstration

video and the South Carolina video competition.• Inter-hospital sharing network.

Mark Your Calendars For The Patient Safety SymposiumColumbia, South Carolina

Fifth Annual Patient Safety Symposium:

April 25th – April 26th, Marriott Hotel, Columbia

• Keynote Speakers:– Atul Gawande– Eric Coleman– David Marx

• Breakout Sessions:– Transitions of Care– How To Make a Safe Apology– Safe Surgery 2015: South Carolina

• Registration for the main conference is $250. • Please ask for your hospital to sponsor you to come.• For more information please contact Mary Stargel, mstargel@scha.org.

Pre-Conference SessionOR Team Training

April 24th

Marriott Hotel, Columbia• Our team is offering a short team training course,

specifically designed for the OR.• Checklist implementation team members or their

designees should attend. This includes physicians that have been involved in this work.

• Train participants to teach the curriculum in their hospitals.

• This training is free of cost.• Registration is limited.• Contact Mary Stargel, mstargel@scha.org for more

information.

Safe Surgery 2015: South Carolina Breakout Session

April 25th• We would like as many people who have

worked with us to attend.• This will be an interactive session where

you can meet people that have been doing this work across the state.

• We hope to share lessons learned and to talk about next steps in this project.

Finalizing Your Hospital’s Checklist:

A Few Reminders

Communication Counts• The easy way out with the checklist is to

remove the communication items.• The communication items make the

difference in American hospitals.• You will know if you have your checklist

right, when you hear everyone’s voice.

Does Our Checklist Contain the Critical Elements?

1. Does your surgical checklist have three phases in the OR, before induction of anesthesia, before skin incision, and before the patient leaves the room?

2. Are the items on the checklist meant to be read aloud, without reliance on memory, so all members of the team can hear them?

3. Does every person that is present in the operating room have the opportunity to say something before skin incision, at a minimum they introduce themselves by name and role or state that they are ready to proceed? (This includes perfusionists, surgical assistants, PAs, residents, observers, manufacturer representatives, and other observers)

4. Will the surgeon share an operative plan and discuss: anticipated blood loss, expected duration of the procedure, possible difficulties, and implants or special equipment needed for the case with the entire team before skin incision?

5. Will the nurses and surgical techs discuss with the entire team their concerns about the patient?

6. Will the anesthesia providers discuss with the entire team the anesthetic plan and airway or other concerns?

Does Our Checklist Contain the Critical Elements Continued:

7. Will the surgeon ask the entire team to speak up if they have any concerns during the case?

8. Before the patient leaves the OR will ALL members of the surgical team discuss equipment problems that need to be addressed, key concerns for recovery and management, and anything that could have been done better to make the case safer or more efficient?

Does Our Checklist Contain the Critical Elements Continued:

We will never know which patient the checklist helps because of information that was shared and problems

that were prevented.

Displaying the Checklist

Testing Roll-Out

• Have circulator hold the checklist up in front of clinicians so they can read their parts aloud.

• Have multiple copies of the checklist in the OR.

• Poster• Electronic Medical Record• Paper

One Size Might Not Fit All• If you have an Ambulatory Surgery Center

they might need a different version of the checklist.

• Cardiac Surgery might also need a different version of the checklist.

• Contact our team at: safesurgery2015@hsph.harvard.edu if you would like do see templates that we have created for these two areas.

Advertising the Checklist

Advertising the Checklist in your Hospital

• Posters• Bulletin Boards• Emails• Hospital Newsletters• Buttons• Competitions• Videos

Stephanie Ziesing

Teresa DevoreAnmed Health, Medicus Surgery Center

This Week’s Homework• Continue to administer the culture survey.

• Have one-on-one conversations with as many people as you can.

• If possible, hold one-on-one conversations with the people that you identified as possible skeptics before you hold a large meeting talking about the checklist.

• Mark your calendars to attend the 2012 April Patient Safety Symposium.

• Create a checklist demonstration video for your hospital.

• Decide if the checklist will be used in paper of poster form.

• Finalize your hospital’s checklist, please send it to us so we can see how you made the checklist work for you.

• Think about ways to advertize the checklist in your hospital.

?Questions

Ask Us a Question By Using the Raise Hand Button

Office Hours:

Next Tuesday from 2:00-3:00

Next Call – Preparation for Expanding to Full

Implementation: PlanningThursday, February 16th

2:00-3:00

Resources

Website:www.safesurgery2015.org

Email: safesurgery2015@hsph.harvard.edu