Using the WHO Surgical Safety Checklist to Direct Perioperative Quality Improvement at a Surgical Hospital in Cambodia: The Importance of ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-12

AUTHORS

Naomi Y. Garland, Sokhavatey Kheng, Michael De Leon, Hourt Eap, Jared A. Forrester, Janice Hay, Palritha Oum, Socheat Sam Ath, Simon Stock, Samprathna Yem, Gerlinda Lucas, Thomas G. Weiser

ABSTRACT

BACKGROUND: The WHO surgical safety checklist (SSC) is known to prevent postoperative complications; however, strategies for effective implementation are unclear. In addition to cultural and organizational barriers faced by high-income countries, resource-constrained settings face scarcity of durable and consumable goods. We used the SSC to better understand barriers to improvement at a trauma hospital in Battambang, Cambodia. METHODS: We introduced the SSC and trained data collectors to observe surgical staff performing the checklist. Members of the research team observed cases and data collection. After 3 months, we modified the data collection tool to focus on infection prevention and elicit more accurate responses. RESULTS: Over 16 months we recorded data on 695 operations (304 cases using the first tool and 391 cases with the modified tool). The first tool identified five items as being in high compliance, which were then excluded from further assessment. Two items-instrument sterility confirmation and sponge counting-were identified as being misinterpreted by the data collectors' tool. These items were reworded to capture objective assessment of task completion. Confirmation of instrument sterility was initially never performed but rectified to >95% compliance; sponge counting and prophylactic antibiotic administration were consistently underperformed. CONCLUSIONS: Staff complied with communication elements of the SSC and quickly adopted process improvements. The wording of our data collection tool affected interpretation of compliance with standards. Material resources are not the primary barrier to checklist implementation in this setting, and future work should focus on clarification of protocols and objective confirmation of tasks. More... »

PAGES

3012-3024

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00268-017-4198-x

DOI

http://dx.doi.org/10.1007/s00268-017-4198-x

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1092242580

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/29038828


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