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Safety and Surgical Checklists

Published byReynard Johnson Modified over 6 years ago

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Presentation on theme: "Safety and Surgical Checklists"— Presentation transcript:

1 Safety and Surgical Checklists

2 Goals and Objectives Care of Neurosurgical Patient
Pre, Intra, and Post-Operative Checklists Validated Tools in the Neurosurgical Setting Environments particular to Neurosurgery Neuromonitoring Intra-Operative MRI Sub-specialty Specific Considerations for Process Quality

3 Surgical Checklists Surgical Time Out (WHO and JCAHO) Components
Prospective Data on 7688 surgical patients Death 1.5% to 0.8%; Complications 11% to 7% Components Correct Patient, Procedure, and Surgical Site Specialty Specific Checklists Adverse Event Division of Labor Intra-Procedural Aneurysm Rupture

4 Checklist Practice Challenges UCLA Prospective Experience
Cultural Change: Who leads surgical pause? Practice Change: 3-5 minute completion Standardization of Time Out Potential for Smart Tailored Checklists

5 Culture of Safety Reporting
Sources of Errors: Communication Multidisciplinary Team Provider Roles in Timeout and Checklists Berger et al. Safety Reporting Video

6 Aviation Incidence Guide
Human Factor Analysis Track, Analyze, Categorize Near Misses Severity and Duration Ferroli et al. (14 near misses) Human Factors (9/14) Technology (1/14) Organizational Factors (3/14) Procedural Factors (1/14)

7 Near Miss Factor Analysis
Human Factors Omission, Lack of Communication, Late Detection Multitasking, Teamwork Failure, Time Pressure Technologies Equipment Allocation, Instruments, Interface, Data Interpretation Organizational Factors task allocation/overlap Procedural Factors (checklist effectiveness)

8 Surgical Debriefing Systems Based Practice Real-Time Quality Feedback
Diversity of Team Member Perspective

9 Patterns of Adverse Events in Neurosurgery
Surgical Technique Perioperative medical management Protocol Use and Adherence Pre-Operative Optimization Technology Communication

10 Solutions Process and Outcomes Monitoring
Regionalization and Subspecialization Guidelines and Protocols Equipment Standardization Surgical Checklists

11 Sub-Specialty Considerations
Spine Intra-Operative Neurophysiological Monitoring Endovascular Intra-Operative MRI

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