Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.
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J U N E 2 0 1 6 O R E X C E L L E N C E . C O M 7 1 ensures that someone is able to speak up if there is something that causes them concern. Most importantly, it is an organization that says that its goal is to have absolutely no avoidable errors, zero, in its facility. • Embrace checklists. In health care, some think checklists are a bad word. We've heard people say that checklists take away the individual's ability to think. But in High Reliability Organizations, it's the opposite. The checklist keeps you from forgetting the most important things, so it frees your mind to analyze and reason, therefore making you a better deliverer of care. But you can't just hand out a checklist and think that it's going to implement itself and instantly make patients safer. It won't. The pre-procedure time out (PPTO) is a great example of this. The Joint Commission has mandated the PPTO for more than a decade, but unfortunately, they didn't give specifics to how it should be carried out, and that's one reason why we haven't yet eliminated avoidable adverse events. Another problem is that surgeons or staffers are often disengaged with the checklist. I compare it to flying a plane. If you got on a plane with a pilot who said that he didn't feel like doing the pre-takeoff briefing, or just rushed through his pre-flight checks, would you want to be on that plane? Clinicians need to look at each patient in that light, since the patients trust them with their lives each and every time they enter that OR. • Staff and surgeon resistance. There's a saying: The only person who likes change is a baby with a dirty diaper. And frankly, we see this inside and outside of health care. People tend to like to do things their own way. One way to inspire change is to make sure that if you are implementing a new checklist or patient safe- ty initiative, you give the specifics and expectations to your team. You can't just say "do the time out" — you need to tell them how to do it, when to do it, why they're doing it, who needs to participate, and how they'll know that they accomplished their goal. OSM