1. Sunnybrook Health Science Centre SSCL

2. About SHSC Academic Teaching Centre Tertiary Care Centre Regional Trauma Centre 2 Campuses 16,000 OR’s per year All specialties

3. SSCL =Good Communication = Better Patient Outcome Ensures correct Patient Surgery medication equipment Supplies Specimen labeling Documentation It’s the right thing to do.

4. Surgical Safety Checklist

5. Pilot Implementation Goals: –Evaluate the logistics of implementing the surgical safety checklist in a few surgical services –Obtain feedback on content and format of checklist –Obtain feedback on the process of completing the checklist –Make improvements to the checklist prior to large scale implementation

6. DRAFT 2009 MayJuneJulyAugSeptOctNovDec PLANNING Introduced by Director at Gallie Day Senior EVP Approached tb Champion To OR Executive Committee Select Team, & Physician Champions Weekly Meetings Feedback/Finalize draft of checklist Communication Advertise, staff level,pilot physicians Building the Case for Change Compile stories Finalize agenda for rounds Accountability list for champions Identify the changes required Determine pilot compliance metrics Finalize data collection method,pilot Assess the impact of change on stakeholders Pilot in general surgery, cardiac and vascular Analyse, review, & post pilot data Risk mitigation plan (addressing barriers) Create a 'what's in it for me' list Develop a communication and roll-out plan Create an action plan with clear milestones

7. DRAFT 20092010 MayJuneJulyAugSeptOctNovDecJanFebMarAprMayJunOngoing IMPLEMENTATION Preliminary/informal communciation to all disciplines (i.e. pre-launch info, staff meeting discussions, one-on-one info, etc.) Finalize data collection method Joint Grand Rounds - official launch Release of first month compliance report - all discipline staff meetings/posted Internal champion in-person audits Ongoing data reporting - to ALL OR staff Staff/physician feedback re: content/process Final checklist revisions (for MOH or staff) Update Senior Leadership & Hospital Board Collate Compliance Data for MOHLTC Public Reporting to MOHLTC Staff satisfaction survey (risk mitigation) Staff satisfaction survey (1-year review)

9. Three Components of checklist Briefing – to be completed while patient is awake Time Out – immediately prior to incision Debriefing – can be conducted while closing All team members to actively participate

12. Checklist Aides Every Operating Room equipped with: –Large laminated wall poster of the Surgical Safety Checklist –Standard size (handheld) laminated copy to guide the discussion Completion of each section captured on OR record START DATE: _____________

13. Checklist Pilot Results 1234

14. Patient Safety Successes during pilot: –Error on pathology form corrected at debriefing –Equipment problem identified (unsterile) during briefing –Heart valve size unavailable identified during briefing –Patient had opportunity to thank OR staff pre- operatively –Residents highly engaged Checklist Pilot Near Miss

15. Sunnybrook Health Science Centre

16. Sustaining Improvement Efforts Process Indicators to be tracked: –Completion of individual checklist, by components (briefing, time out, debriefing) Monthly reports on our compliance success to OR Management Near misses prevented by the SSC documented on safety reports