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Using ‘failure mode and effects analysis’ to design a surgical safety checklist for safer surgery
Author(s) -
Chan Danny T.M.,
Ng Simon S.M.,
Chong Yee Hung,
Wong John,
Tam YukHim,
Lam YukHoi,
Chan ChiKwok,
Wong David S.Y.,
Wan Innes Y.P.,
Wong Simon K.H.,
Ng Bobby K.W.,
Cho Amy M.W.,
Yu KwokHung,
Chan HingSang,
Li Wing See,
Ng Alex,
Wu Terry S.F.,
Chiu Alick,
Fong Ada S.L.,
Liu Yat Wo,
Lai Paul B.S.
Publication year - 2010
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/j.1744-1633.2010.00494.x
Subject(s) - checklist , medicine , audit , patient safety , safer , medical emergency , nursing , health care , computer science , psychology , computer security , management , economics , cognitive psychology , economic growth
Aims: To describe the process of designing a new surgical safety checklist for the prevention of wrong patient and wrong site/side surgery using ‘failure mode and effects analysis’ (FMEA), and to carry out a compliance audit on the use of the new checklist in a surgical department. Methods: Using FMEA as a tool, a multidisciplinary team of medical professionals in the New Territories East Cluster of the Hospital Authority sought to identify key steps at‐risk associated with a patient's journey through elective surgery. The whole process was redesigned and incorporated into a new safety checklist with a view to preventing wrong patient and wrong site/side surgery. A compliance audit was carried out after implementation of the checklist. Results: The newly designed safety checklist, known as ‘123‐Surgical Safety‐123’, involved a longitudinal series of checkpoints from upstream to downstream with repeated/redundant cross‐checking at key steps. The checkpoints included consenting process, sending of patient to the theatre, theatre reception, sign‐in, time‐out, and sign‐out. At each step, one designated person (either a doctor or a nurse) was responsible for checking the correctness of those items listed on the checklist. The new checklist was implemented in February 2009. A compliance audit on the use of the checklist was carried out between 13 February and 17 April 2009. A total of 322 patients were operated on during the study period. The overall compliance rate was 95%. Conclusion: By using FMEA as a platform, a new surgical safety checklist for prevention of wrong patient and wrong site/side surgery was designed and successfully implemented in a surgical department. A high compliance rate was achieved. However, whether or not the implementation of this new checklist will improve the outcome of surgical patients still awaits further evaluation.