Everyone has Their Role to Play During the World Health Organisation Surgical Safety Checklist in Australia: A Prospective Observational Study.

Abstract

The World Health Organisation Surgical Safety Checklist (SSC) is a mandated part of surgical practice. Adherence to the SSC has been shown to result in improved patient outcomes. The aim of this study was to determine the current adherence to the timeout section of the SSC and, in particular, the function of individual team members. A prospective pre- and post-intervention observational audit was conducted on the timeout section. The intervention involved an in-hospital display of interim results and distribution to theatre staff. Data were collected on participants, duration and compliance with checklist items for 400 theatre cases. There were 200 cases before and after the intervention. There were no cases in which the timeout section was completed correctly in its entirety. Post-intervention, there was a significant improvement in participation of theatre staff (excluding surgeons) as well as a significant improvement in items discussed and documented. Discussion of items such as anticipated critical events, pressure areas and the team introduction remained low. Some items on the checklist were discussed significantly more when a particular staff member participated. Observed completion rates of the timeout section of the SSC were poor. Individual team members positively influenced checklist items more aligned to their role, highlighting the importance of timeout being performed by the entire theatre team. Improved performance was seen following audit and feedback.