1. Webinar 11: Preparation for Expansion to Full Implementation – Planning

2. Summary of Last Week’s Call Patient Safety Symposium Announcements. Finalizing your hospital’s checklist, a few reminders. Advertising this project in your hospital. Two ASC’s will shared how they advertized the checklist in their facility.

3. How Did the Homework Go?

4. Homework to Date Slide 1 of 3 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 3 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 3 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 how you will advertise the checklist. Mark your calendars for the April Patient Safety Symposium (April 24 th – 26 th )

7. Poll 1: How Do You Think You Will Advertize the Checklist? (Please Check All That Apply) Posters Bulletin Boards Emails Hospital Newsletters Buttons Competitions Creating a Demonstration Video Other

8. Poll 2: How is the Culture Survey Administration Going? We haven’t started yet About half of our physicians and staff have completed it. We are almost done. We are done.

9. Today’s Topics 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? How to scale the checklist. Prioritizing surgical specialties for the roll-out. Inter-hospital sharing network.

10. Displaying the Checklist: A Few Reminders

11. Displaying the Checklist Make sure every member of the surgical team can read a hard copy of the checklist. Make sure that every item on your checklist is in clear language. A larger checklist displayed in the OR signifies the importance of using it.

12. Poll 3: How Will You Display The Checklist When You Roll it Out? (Please Check All That Apply) Paper Poster EMR

13. Training Your Colleagues Using A Video A picture is worth a thousand words. You can show people how the checklist should by showing them. While it is helpful it cannot be the only method of teaching people how to use the checklist.

14. Video Guidelines Do not film video over a live patient. Use an empty OR, conference room, or simulator. Shoot the video with a portable camera, phone, or anything that you have available.

15. Submit Your Videos for the South Carolina Checklist Video Competition Create a checklist demonstration video using your hospital’s version of the checklist and/or a video of a poorly done Joint Commission “Time-Out”. The winning video in each category will be highlighted on the national website and will be incorporated into program presentations. All individuals shown in the video will need to sign a release form. Contact us to get the release form. All videos need to be sent to the Safe Surgery 2015: Team by April 6 th, 2012. The winner will be announced at the April Patient Safety Symposium.

16. Poll 4: Are You Planning on Creating a Demonstration Video? Yes No We are still thinking about it

17. Reflect on What Worked When You Tested the Checklist Arrange things in order of anticipated difficulty. Start with the surgeon or service that you think will be the most accepting. Create a timeline. Be flexible. Give enough time to do the work. It always takes longer than people initially think. Assign a member of the checklist implementation team to the area that will be using the checklist. They will be available to talk to surgical teams and trouble shoot any problems.

18. How Do You Organize a Checklist Roll-Out? Use your OR Personnel Spreadsheet and rank the services

19. Small Hospitals < 4 ORs One room/surgeon each day. Talk to everybody on the surgical team before they use the checklist for the first time.

20. Example Timeline for Small Hospital DateServiceImplementation Team Member Assigned to talk to them SurgeonMembers of the Surgical Team Anticipate d Difficulty Monday, July 11 th GeneralSueDr. SmithRita, Mandy, and Dr. Jones. Easy Tuesday, July 12 th GeneralSueDr. BerryJoanne, Rick, and Dr. Foster Easy Wednesd ay, July 13 th GeneralKatieDr. JonesRita, Mandy, and Dr. Jones Moderate Thursday, July 14 th, OrthoDr. StraussDr. SminkJoanne, Rick, and Dr. Foster Difficult

21. Medium to Large Hospitals ~ one service per week. Talk to every member of the surgical team prior to when they use the checklist for the first time.

22. Service Line Roll-out Timeline WeekServiceDifficulty Week 1General SurgeryEasy Week 2Plastic SurgeryEasy Week 3Transplant SurgeryEasy Week 4Trauma SurgeryModerate Week 5UrologyModerate Week 6ENTDifficult Week 7Cardio-Thoracic SurgeryDifficult

23. Example of a Week DateServiceImplementation Team Member Assigned to talk to them SurgeonMembers of the Surgical Team Anticipated Difficulty Monday, July 11 th GeneralMaryDr. MooreCN – Joan Anderson Scrub – Suzanne White CRNA – Chris Jones Easy Tuesday, July 12 th GeneralEricDr. BerryCN – Linda Johnson Scrub – Lisa Jackson Anesthesiologist – Paul Harris Easy Wednesday July 13 th GeneralEricDr. JonesCN – Rita Moore Scrub – Judy Allen CRNA – Debra Hughes Moderate Thursday, July 14 th GeneralDr. StraussDr. SminkCN – Joan Anderson Scrub – Ann Fisher Anesthesiologist – Randall Johnson Difficult

24. Collect Feedback Appoint a member of the implementation team to be the point of contact for individuals to talk to. If you are using a paper checklist have a space to write comments on the back. Set-up a short survey and ask people to complete it throughout the entire implementation process.

25. Inter-Hospital Sharing Network

26. Poll 5: Would You Like to Participate in the Inter-Hospital Sharing Network? Yes Maybe, please send me more information Not right now

27. 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. Start your checklist advertising 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.

28. Mark Your Calendars For The Patient Safety Symposium Columbia, South Carolina

29. ? ? Questions

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

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

32. Next Call: Implementing the Checklist Thursday, February 23 rd 2:00-3:00

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