1. Webinar 12: Best Practices

2. Summary of Last Week’s Call Displaying the checklist: A Few Reminders. Training your colleagues using a demonstration video and the South Carolina video competition. Creating timelines and setting goals for expanding the checklist. Reflecting on how you tested the checklist. –What went right? –Why did it work when you tested it? Scaling the checklist. Prioritizing surgical specialties for the roll-out. Inter-hospital sharing network.

3. How Did the Homework Go?

4. Homework to Date Slide 1 of 4 Build an implementation team. Schedule a time and venue for a meeting to take place after January. Download the OR Personnel Spreadsheet from our website and begin completing the information with the names, roles, and email addresses if relevant. Review the checklist modification guide and South Carolina Checklist Template. Modify the checklist with your implementation team and use it in a “table-top simulation”. Test the checklist with one team and modify if necessary.

5. Homework to Date Slide 2 of 4 Email us a picture of your checklist implementation team. Identify departmental meetings to have the implementation team speak after call 10. Expand the testing of the checklist to one team using the checklist for every case for one day. Modify the checklist as necessary. Email us your hospital’s checklist. If you haven’t already done so, please call or email our team about whether you would like to administer the culture survey. Email everything to safesurgery2015@hsph.harvard.edu

6. Homework to Date Slide 3 of 4 Identify people that you think will be skeptical of using the checklist and try to talk to them before you hold a large meeting. Organize and conduct one-on-one conversations. Create a checklist demonstration video for your hospital. Decide if the checklist will be used in paper or poster form. Finalize your hospital’s checklist, please send it to us so we can see how you made the checklist work for you. Think about you will advertize the checklist.

7. Homework to Date Slide 4 of 4 Start your checklist advertizing campaign. Prioritize surgical specialties for the roll-out using your knowledge of which surgeons will be most receptive to the checklist. Create a timeline for your hospital’s expansion and send it to the Safe Surgery 2015 team. Start holding departmental meetings in the service that you are putting the checklist into place next. Mark your calendars for the April Patient Safety Symposium (April 24 th – 26 th )

8. Poll 1: Tell Us What You Did When You Tested the Checklist? (Please Check All That Apply) We started with the people that would be willing to use the checklist. We talked to everybody on the surgical team about the checklist prior to them using it in the OR. The surgical teams practiced using the checklist outside of the OR before they used it with a patient. We collected feedback on what went well and what needed to be fixed. We were available to answer questions and to help teams if they had an issue.

9. Today’s Topics Making the debriefing count. Tips on engaging your colleagues when you talk about the checklist at departmental meetings or in large inter disciplinary meetings. SCHA Hospital Visits: The Best of South Carolina Hospitals.

10. Making the Debriefing Count Mike Rose, MD Chairman, Leadership Team Vice President of Surgical Services McLeod Health Board of Trustees

11. Poll 2: Do You Already Have a System In Place to Collect Feedback From Surgical Teams About Equipment Problems That Need To Be Addressed and Then Fix Them? Yes No We are actively working on putting one into place.

12. Tips on engaging your colleagues when you talk about the checklist at departmental meetings or in large inter-disciplinary meetings.

13. Start The Meeting By Sharing A Story We have provided a story in the presentation templates. Think of something that happened in your hospital or in a previous place where you have worked. Don’t share a story that can be traced to somebody in the audience.

14. Ask People In The Audience To Help You Ask one of your colleagues who is sitting in the audience to share a story about something that they have seen that could have been helped by the checklist, better teamwork, or improved communication.

15. The “Scrub Sink Trance”

16. “Reverence for Induction”

17. “Respect for the Counts”

18. The Team Kimberly Hubbard, MHA Project Coordinator SCHA Ashley Kay Childers, PhD Systems Engineer SCHA Clemson University

19. Site Visits Overview Visits to observe the checklist in action. We’ve visited more than 30 hospitals and would like to visit each of you at least once. Verbal debrief on the day of the visit with a formal report to follow to discuss the strengths and opportunities for improvement. Feedback also goes to Harvard team to help us learn about you and shape Safe Surgery 2015: SC.

20. Engagement Engage everyone on the staff –Representatives from each department on the implementation team can serve as liaisons to staff –Ask for commitment Engage the leadership –Simulations –Observations Engage the patients

21. Checklist Execution Hard stops, huddle around the patient for pre- anesthesia and pre-incision portions Wait until every is ready Review checks from a hard copy –Do not rely on memory –Paper copy, poster on the wall, displayed on monitors, pocket cards, sterile cards, ID badges, etc. –Review checks in order; do not omit –Conversational flow Everyone should participate –Introductions are important –Designate talking points

22. Education Newsletters, posters, flyers, emails, logos –Horton Hears a “WHO” buttons –Safe Surgery 2015: SC logo Saves / good catches Explain rationale of each check, purpose of Safe Surgery 2015: SC initiative, etc. Re-education!! Morning huddles

23. Other interesting ideas Debriefing output used for QI Finding surgeon champions Eliminate the excuses Learn from Safe Surgery 2015 hospital network Personalized checklist to the facility Student Site Visits

24. Contact US Ashley Kay Childers childer@clemson.edu Kimberly Hubbard khubbard@scha.org

25. This Week’s Homework Continue to: –Administer the culture survey. –Have one-on-one conversations with as many people as you can. Mark your calendars to attend the 2012 April Patient Safety Symposium. Continue to hold departmental meetings. Hold the large inter-disciplinary meeting that you scheduled at the beginning of the call series. If you are ready, start implementing the checklist over the next week with the service/surgeons that you think will be most receptive.

26. ? ? Questions

27. Ask Us a Question By Using the Raise Hand Button

28. Office Hours: Next Tuesday from 2:00- 3:00

29. Next Call: Implementation Barriers Thursday, March 1 st, 2012 2:00-3:00

30. Resources Website: www.safesurgery2015.org Email: safesurgery2015@hsph.harvard.edu