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Introduction and validation of a surgical ward round checklist to improve surgical ward round performance in a tertiary vascular service
Author(s) -
TranterEntwistle Isaac,
Best Katherine,
Ianev Ross,
Beresford Timothy,
McCombie Andrew,
Laws Peter
Publication year - 2020
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.15899
Subject(s) - checklist , medicine , patient safety , quality management , chart , time out , adverse effect , emergency medicine , health care , medical emergency , nursing , service (business) , psychology , statistics , economy , mathematics , economics , cognitive psychology , economic growth
Abstract Background Surgeons administer care in an increasingly complex clinical environment. Time constraints put strain on individual clinicians and the multidisciplinary team, increasing the risk of human errors. The World Health Organization surgical checklist has shown to mitigate this risk perioperatively. We describe the development, introduction and outcomes of a novel ward round safety checklist. Methods The vascular team ward rounds at Christchurch Hospital were assessed over a 2‐week period for ward round quality indicators. A ward round safety checklist was developed and then introduced. Two further assessments were conducted to evaluate for improvement in the ward round quality indicators. Ward rounds were timed with the length of each consultation recorded and staff perception assessed. Results Significant gains across both clinical indicators and staff feedback measures were observed. Of the 21 ward round quality indicators, 20 showed statistically significant improvement, as did all subjective measures. Significant improvements included observation chart review (20% to 75% to 81%), drug chart review (10% to 54% to 78.6%) and anticoagulation/antiplatelet treatment (32% to 61% to 58.1%) ( P < 0.05). Mean consultation time per patient did not increase (3 min 58 s to 3 min 48 s and 4 min 30 s) ( P = 0.857 and P = 0.119). Conclusion This study provides evidence that introducing a structured ward round safety checklist improved ward round quality, without adversely affecting consultation time. The familiar checklist structure promotes its acceptance and team cohesion. Whether the improvements observed translate to improved patient outcomes and reduced adverse events reporting is the subject of ongoing study.

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