alone, there were 75 reports of wrong-site surgery in 2017. Those trou-
blesome trends should motivate you to optimize use of the surgical
checklist to ensure surgeons perform the right procedure at the right
site and on the right patient. Here's how we did it.
1. Safe starts
In pre-op, the surgeon, a nurse and the anesthesia provider verify the
patient's identity and the procedure site and side. We built our facili-
ty's safety checklist into our electronic health record and require that
staff complete the pre-op verifications — what we call "hard stops" —
before we can move the patient to the OR. In fact, staff are unable to
complete the pre-op documentation in the EHR if the safety checks
are not entered.
To avoid errors in the pre-op and holding area, we ask that sur-
geons' schedulers send patients' primary documents — physicians'
orders, surgical consents and imaging reports — 48 hours before
scheduled procedures. That give us enough time to review the pages
and identify discrepancies that we need to address before we refer-
ence the information during pre-op safety checks.
2. Make it useful
All checklists should help your surgical team confirm the correct
patient, procedure and site; address the patient's allergies; adminis-
ter pre-op antibiotics; and procure all equipment and images needed
for the case. But it's not intended to be a one-size-fits-all document
— you're expected to tweak the template to meet the specific needs
of your facility. For example, we added a section to guide the
debriefing our surgical team completes at the end of the procedure,
before we move the patient to PACU. The checklist prompts staff as
they discuss how the procedure went and safety concerns that need
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